CVSRA New Member Registration

Administrative Use Only

First Name

Last Name

This is where you live

Address

2nd Address

City

State

Zip

Confirm Email

Phone

Cell Number

(###)

###

####

Cell Carrier

Are You USSF Certified?

If USSF certified what is your grade?

Grassroots/Regional

If USSF certified what state is your certification in?

Date of Birth

YYYY

Gender

Parent's Cell (if under 18)

(###)

###

####

Parent's name and relationship if number is provided above

CVSRA assigns regular season matches in Richmond, Chesterfield, Powhatan, Hopewell, Ashland, Mechanicsville, Fredericksburg & Charlottesville. We assign all levels of soccer including youth travel - recreation, adult premier - recreation, youth tournaments, Middle School, High School.

Check All that you are interested in:

Regular Season Youth and/or Adult Matches

I am at least 16 and want to be considered for Middle School matches.

I am at least 18 and want to be considered for High School matches.

Though not local the CVSRA area, I am interested in working CVSA adult league matches occasionally (excellent for those interested in upgrading)

Tournaments only (Once this registration is processed you will be contacted for specifics)

I agree to the CVSRA mobile text terms and conditions

I agree to CVSRA photo and video use terms and conditions available here.

Protocols can be found at a link on our home page.

I have read and agree with CVSRA Covid-19 Protocol and understand by accepting any assignment I am agreeing to follow the current protocols.

Signature

This verifies that you agree to read and follow CVSRA policies and procedures and that all information provided is correct.

Within 2 weeks of submission of this form you should be contacted by a CVSRA assignor with information regarding member set up and assigning procedures. If you do not hear from one within 2 weeks, please email Head Assignor, Beth Hatchel, at cvsra.assignor@gmail.com