Registration - Albany Empire Soccer Club

Instructions Interested in joining the Albany Empire? Please submit the form below. We look forward to meeting you!
First Name
Last Name
Birthday *
Gender Identity *
Preferred Gender Pronouns
Primary Phone
Email *
Email Again *
Password *
Membership Level *
New Recruit - NonMember
Skill Level
Preferred Field Position *
Where did you hear about us?
Emergency Contact
Emergency Contact Name
Emergency Contact Number
Emergency Contact Number
Emergency Contact Relation
Emergency Contact Relation
Additional Comments
Leave any additional comments here!