BOYS FIELD ... - League Athletics
Thank you for choosing to play GIRLS/BOYS FIELD HOCKEY with ALLIED SPORTS OF VIRGINIA’S Field HOCKEY Program. You have selected to PAY BY CHECK for the program you have registered for. Please print off the registration form below, complete it and mail it along with your check to: (make checks payable to “ALLIED SPORTS OF VIRGINIA”) Mailing Address: ALLIED FIELD HOCKEY 5406 Chestnut Bluff Road Midlothian, VA 23112 If registering more than one player a separate registration form must be completed. Players are not considered registered with ASOV until this form and payment have been received by our office. You will need to turn in a medical release form to the coach at the first practice. If you would rather register online and pay by credit card please select FIELD HOCKEY WEBSITE and click on REGISTER NOW on the right side of the home page. Thanks, ALLIED SPORTS FIELD HOCKEY 804-647-1441 www.ALLIEDFIELDHOCKEY.com
WE DO SPORTS….
FIELD HOCKEY, LACROSSE, AND SOCCER
GIRLS/BOYS FIELD HOCKEY SPRING2009 REGISTRATION FORM: ___________________________________ PLAYER’S FIRST NAME
_________________________________________________ PLAYER’S LAST NAME
________________________________________________ STREET ADDRESS
_____________________________________( ) SCHOOL ATTENDED GRADE
_________________________________________ CITY
___________ STATE
____________________ ZIP CODE
__________________________ CELL PHONE
____________________ DATE OF BIRTH
_____________________________ HOME PHONE
____________________________________________________________________________________________ PRIMARY FAMILY E-MAIL ADDRESS # OF SEASONS PLAYED: ________________
T-shirt SIZE (CIRCLE ONE):
N/A
YS
POSITION PREFERENCE: ________________
YM
YL
AS
AM
AL
AXL
AXXL
CONSENT: I/we, the parent(s)/guardian(s) of the above participant, hereby give my/our approval to their participation in the sports program of Swift Creek Field Hockey. I/we assume all risks and hazards incidental to such participation, including transportation to and from activities, and I/we do hereby waive, release, absolve, indemnify, and agree to hold harmless the Swift Creek Field Hockey, the organizers, sponsors, supervisors, participants and persons transporting my/our youth to and from activities for any claim arising out of injury to my/our youth, whether the result of negligence or any other cause, except to the extent and in the amount covered by accident or liability insurance. I/we will also furnish a copy of a Certified Birth Certificate for the above named participant on or before the day of the first game. REFUND POLICY: There will be no refunds for any reason other than the following: Unable to place a child on a team Players medically unfit to play the first scheduled game (documented by physician's statement) ALL REFUND REQUESTS MUST BE MADE BY MAIL ALLIED WILL NOT EXCEPT EMAIL OR PHONE CALL REQUESTS FOR REFUNDS __________________________________________________________________ PARENT/GUARDIAN SIGNATURE
FATHER/GUARDIAN
____________________________________ DATE
FIRST
LAST NAME
WORK #
CELL #
MOTHER/GUARDIAN FIRST
LAST NAME
WORK #
CELL #
VOLUNTEERS ARE NEEDED: Circle your choices Coach Assist Coach Tournament Volunteer Registration Fee: $85 (U11-U19): $50 (U7-U9) Mail application and check to: ALLIED SPORTS OF VIRGINIA 5406 CHESTNUT BLUFF ROAD Midlothian, VA 23112 WE DO SPORTS….
FIELD HOCKEY, LACROSSE, AND SOCCER
WE DO SPORTS….
FIELD HOCKEY, LACROSSE, AND SOCCER
GIRLS/BOYS FIELD HOCKEY SPRING2009 REGISTRATION FORM: ___________________________________ PLAYER’S FIRST NAME
_________________________________________________ PLAYER’S LAST NAME
________________________________________________ STREET ADDRESS
_____________________________________( ) SCHOOL ATTENDED GRADE
_________________________________________ CITY
___________ STATE
____________________ ZIP CODE
__________________________ CELL PHONE
____________________ DATE OF BIRTH
_____________________________ HOME PHONE
____________________________________________________________________________________________ PRIMARY FAMILY E-MAIL ADDRESS # OF SEASONS PLAYED: ________________
T-shirt SIZE (CIRCLE ONE):
N/A
YS
POSITION PREFERENCE: ________________
YM
YL
AS
AM
AL
AXL
AXXL
CONSENT: I/we, the parent(s)/guardian(s) of the above participant, hereby give my/our approval to their participation in the sports program of Swift Creek Field Hockey. I/we assume all risks and hazards incidental to such participation, including transportation to and from activities, and I/we do hereby waive, release, absolve, indemnify, and agree to hold harmless the Swift Creek Field Hockey, the organizers, sponsors, supervisors, participants and persons transporting my/our youth to and from activities for any claim arising out of injury to my/our youth, whether the result of negligence or any other cause, except to the extent and in the amount covered by accident or liability insurance. I/we will also furnish a copy of a Certified Birth Certificate for the above named participant on or before the day of the first game. REFUND POLICY: There will be no refunds for any reason other than the following: Unable to place a child on a team Players medically unfit to play the first scheduled game (documented by physician's statement) ALL REFUND REQUESTS MUST BE MADE BY MAIL ALLIED WILL NOT EXCEPT EMAIL OR PHONE CALL REQUESTS FOR REFUNDS __________________________________________________________________ PARENT/GUARDIAN SIGNATURE
FATHER/GUARDIAN
____________________________________ DATE
FIRST
LAST NAME
WORK #
CELL #
MOTHER/GUARDIAN FIRST
LAST NAME
WORK #
CELL #
VOLUNTEERS ARE NEEDED: Circle your choices Coach Assist Coach Tournament Volunteer Registration Fee: $85 (U11-U19): $50 (U7-U9) Mail application and check to: ALLIED SPORTS OF VIRGINIA 5406 CHESTNUT BLUFF ROAD Midlothian, VA 23112 WE DO SPORTS….
FIELD HOCKEY, LACROSSE, AND SOCCER
