dallas youth athletic association

DALLAS YOUTH ATHLETIC ASSOCIATION





PLAYER REGISTRATION FORM FORMULARIO DE INSCRIPCIÓN DE JUGADOR

20______ Season (Temporada) Circle One > Age Group (Edad de Grupo) Circle One >

Spring Primavera

4

Summer Verano

Fall Otoño

6

7

5

Sport (Deporte) Circle One >

8

9

10

Baseball Béisbol

11

12

Soccer Fútbol

13

14

15

ONLY answer, if player is returning to league. If not, leave blank. (SOLO responde, si el jugador está regresando a la liga. Si no, deje en blanco.)

TEAM NAME:

HEAD COACH’S NAME: PLAYER PLACEMENT

Player’s Name (Nombre del Jugador) Month Mez

Player Date of Birth (Fecha de Nacimiento) Address w/Apt # (Domicilio w/Apt #)

Day Dia

Year Año

By my signature below, I acknowledge and understand that: (1) the submission of this application does not guarantee participation in this Program; (2) NO guarantee is made to a player’s preferred coach, team and/or age group selection as such placement is subject to the Program’s rules, guidelines, availability and/or discretion; (3) NO person is guaranteed a COACH assignment; (4) NO person has the ability to guarantee any player’s placement on any team.

Age Edad

City / Zip Code (Ciudad / Codigo)

Parent / Guardián #1

RULES OF CONDUCT

Cell #1

All players, parents, and coaches must comply with playing and conduct rules. Any violations of such rules, all punishment will be decided by governing body. And no appeals will be allowed.

Email #1 Parent / Guardián #2

PARENT SUPPORT

Cell #2

We ask for active participation of all parents in our program. Check area(s) in which you would be willing to help.

Email #2

□ Head Coach □ Team Parent

FOR LEAGUE ONLY: PHOTO # PHOTO DATE PLAYER ID # REG FEE MISC FEE TOTAL CHECK #

$ $ $ * Fee for Return Checks: Visit website for policy

Name on Check (On Check: Write Issuer’s ID # + Ph # + Sport + Age/Team Name + Child’s name)

Received by Assignment Staffer Coach Assignment Coach Ph # Age / Team Assignment Date Assigned

www.dallasyouthbaseball.org

□ Assistant Coach □ Scorekeeper

☐ Other _______________________

AGREEMENT / WAIVER By my signature below, I being the parent/guardian of the player (a minor) agree that my child and I will abide by the rules of DYAA, its affiliated organizations (DYB, DYS, DSA, OCSG, i.e.) and/or its sponsors. Payment of fees does not guarantee participation in the Program. By my signature below, I understand that DYAA and its affiliates have the discretion of terminating my child’s participation for any reason at any time prior to and/or during the season and that all refunds, if any, are subject to the discretion of DYAA. Recognizing the possibility of physical injury associated with all sports and in consideration for accepting my child into its sports programs and activities (the “Program”). By my signature below, I hereby release, discharge, or otherwise indemnify DYAA and its affiliated organizations, sponsors, their board members, employees and associated personnel, including a participating player should injury of any kind occur as a result of my child’s participation in the Program which I hereby authorize. By my signature below, provided such use is related to my child’s status as a participant in the Program, I hereby grant DYAA, its affiliated organizations, and/or sponsors the right to share my information with them and to use the player’s (my child) name, pictures, and/or likeness in print, internet, or other manner of broadcast, or distribution in connection to the Program (any objection must be done, in writing, before the start of each season).

See websites for League Policies, Spanish, etc. Consulte los sitios web para Políticas de la Liga, Español, etc. SIGNATURE / FIRMA de PARENT/GUARDIAN

X Reg. Date

www.dallasyouthsoccer.org