First, are you answering for yourself or for your child?

First, are you answering for yourself or for your child?*

For myself

For my child

What is your child's name?

Child's Name

What age group do they fall into?

What age group do they fall into?*

18 months to 6 years old

6 to 8 years old

9 to 12 years old

13 to 15 years old

16+ years old

What is their level of experience playing futsal/soccer?

What is their level of experience playing futsal/soccer?*

Newbie - no prior experience

Beginner - played some before

Intermediate - play often recreationally or in school

Advanced - play regularly at a competitive level

Other than having fun, what goals do they hope to accomplish in their program at Rose City Futsal?

Select all that apply

Other than having fun, what goals do they hope to accomplish in their program at Rose City Futsal?*

They have a group of friends that want to play together

They want to develop their skills and technique

They want to take classes

They want to compete with other advanced players at a high level

Do you prefer they play on a weekday or weekend?

Do you prefer they play on a weekday or weekend?*

Weekday

Weekend

No preference

What age group do you fall into?

What age group do you fall into?*

Under 18

Over 18

What would you consider your level of experience to be playing futsal/soccer?

What would you consider your level of experience to be playing futsal/soccer?*

Newbie - no prior experience

Beginner - played some before

Intermediate - play often recreationally or in school

Advanced - play regularly at a competitive level

Other than having fun, what goals do you hope to accomplish in your program at Rose City Futsal?

Select all that apply

Other than having fun, what goals do you hope to accomplish in your program at Rose City Futsal?*

I have a group of friends that want to play together

I want to develop my skills and technique

I want to take classes

I want practice/instruction in addition to my school program, or in the offseason

I want to compete with other advanced players at a high level

Do you prefer playing on a weekday or weekend?

Do you prefer playing on a weekday or weekend?*

Weekday

Weekend

No preference

What goals do you hope to accomplish in your program at Rose City Futsal?

Select all that apply

What goals do you hope to accomplish in your program at Rose City Futsal?*

I’m looking to play casually

I want a way to socialize with friends and/or other adults

I want to develop my skills and technique

I want to take classes

I want to compete with other advanced players

Do you have a group put together to play with?

Do you have a group put together to play with?*

Yes, I have a group put together

No, I want to be matched with a group

Do you prefer playing on a weekday or weekend?

Do you prefer playing on a weekday or weekend?*

Weekday

Weekend

No preference

Do you have a preference on playing with co-ed teams, or with teams of the same gender?

Do you have a preference on playing with co-ed teams, or with teams of the same gender?*

Co-ed teams

Teams of the same gender

I have no preference

Lastly, please provide us with your information so we can follow up with our recommendations!

First Name*

Last Name*

Phone*

e.g. (###) ###-####

Email*

e.g. email@domain.com

Player's Gender*

Male

Female

Non-binary

Gender not listed

Player's Birthdate*

Preferred Location*

Rose City Futsal East - NE Portland

Rose City Futsal West - Tigard

Either Location

Notes*