[Insert League/Club Name] Dual Form
All fields are required
Player’s First & Last Name:________________________________________________________________________________
Player’s Date of Birth: ___________________________________________________________________________________
E-mail Address:_________________________________________________________________________________________
Street Address:_________________________________________________________________________________________
City: ______________________________________________________________ State: __________ Zip: ________________
Home or Cell Phone: ____________________________________________________________________________________
Primary Team Name: ____________________________________________________________________________________
Primary Team Age Group: ___________________________________________ Gender: _____________________________
Primary League Name: ___________________________________________________________________________________
Primary Coach’s Name:___________________________________________________________________________________
Primary Coach’s E-mail:__________________________________________________________________________________
Secondary Team Name: __________________________________________________________________________________
Secondary Team Age Group:____________________________________________________Gender: ___________________
Secondary League Name: ________________________________________________________________________________
Secondary Coach’s Name:________________________________________________________________________________
Secondary Coach’s E-mail: ________________________________________________________________________________
A player may register with up to two teams per seasonal year. Permission to allow or not allow dual registered players is the MSYSA member
organization jurisdiction.
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The member organization dual registration form (if applicable) must be completed with appropriate signatures before the MSYSA member
organization will consider approving the dual registration.
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A player may not play for more than one team in the same competition (meaning MSYSA sanctioned tournament, MSYSA State Cup,
MSYSA member organization league division, etc.). A player must play on the primary team in the MSYSA State Cup.
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In all cases of dual rostering involving a Midwest Regional League team (MRL), the MRL team must be the primary team.
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In all cases of dual rostering involving a Michigan State Premier Soccer Program (MSPSP) team and a non-MRL team, the MSPSP team must
be designated as the primary team.
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In all other cases, the team with which a player first registers must be designated as the primary team and the other team must be
designated as the secondary team. MSYSA member organization may change the primary and secondary designation if appropriate after
the initial team registration.
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An individual player may NOT dual roster on a MRL team and a MSPSP team. A team that plays in both the MRL and MSPSP must have
identical rosters.
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If the coaches of the two teams disagree on the designation of the primary team, the player may not play until the registration issue has
been resolved By the MSYSA member organization.
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A dual rostered player shall be issued two US Youth Soccer passcards, one for each team.
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Any player who registers for a team without informing the responsible team official and member organization official that they already
registered with another team shall forfeit all games for this team for the time period that the player has not obtained the approval for dual
registration from MSYSA member organization.
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Dual registrations will not be permitted by MSYSA during the months of May, June, October and November, unless a hardship case exists
and approval is provided by MSYSA.
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No Player dual registration form or fee is required to be submitted to MSYSA.
Player (if 18) or Parent’s Signature & Date: ___________________________________________________________________
Primary Team Club or Coach Signature & Date: _______________________________________________________________
Secondary Team Club or Coach Signature & Date: _____________________________________________________________
Primary League Official Signature & Date: ___________________________________________________________________
Secondary League Official Signature & Date:__________________________________________________________________