Citv: State: Zip: Primarv Phone - AWS

BCYSA Boone County Youth Soccer Association

for U8-U13 LATE Late registrations are due by Jan 25, 2018**** This lqte form willonlv be accepted untilJan 25. no team requests will be honored at this time LATE Spring 2018 Registration Form

****All

Registration lnsrudions Note: Do not use this form for Under 5 registration. Players born after July 3t,2O7L should use the Under 6 registration form. The age the is the age group the child will be placed in {example: if child was 8 he would be in U10). Deadline for late player

child was on July 31, ZOLT

no registrations will be accepted registratlon is Jan 25, 2018. The late registration fee is now $80 and no team requesB w after lan 25. For any league questions please call (859)525-1070, for any U8-U13 registration info please visit our website: r,vwr,v.boonecountysoccer.com. Please fill out this form completelv and return it to the address listed at the bottom of the form, do not return forms to the schools or coaches. Make sure to include a check made out to the BCYSA for 580.00 (referee fees will be collected by each coach at the start of the season). The BCYSA will charge S2S for any returned check. First time players must include a copy of their

birth certificate. Player Placement Being that this is now late registration, No placement requests

will be honored during this time and requests for specific practices days or

practice fields will not be accepted. The league will not refund registration fees after Feb 1, for any reason. lf the child cannot be placed on any team, the check will be retumed. ReEistrations wilt not be accepted over the phone or through the internet. Please note that in recreational soccer coaches cannot request who is olaced on their teams. All forms and guidelines can be found online atl www.bocnecountvsoccer.com.

Plaver lnformation Plaver

Narne:

Home

Address:

Primarv

Date of

Phone:

Birth: /

..

Alternate

Gender;

State:

Citv:

-

/

Phone:

M

Zip:

-

Mother/Father Guardian

Name:

What school does the child attend? Did the child olav in the BCYSA durinp the Fall 2017

EmailAddress: Todat's

Yes

No

Aee Grouo

date: I

olaved:

I

U5 U8 U10 U13

lf child plaved Fall 2017 who was the coach?

the child plavins select soccgr too? Y N NO TEAM PTACEMENT BEQUESTS CAN BE HONORED, CHlL"O WILL Bt PLACED BANDOM WHERE NEEDED

Does the child wish

Additional

to olav uo in an older aee sroup?

Yes No

Is

comffients: {l agree that the BCYSA or its representatives will not be held responsible for any accidents or injuries received while partkipating)

Parent/Guardian Sisnature Mail this eompleted late reglstration form along with a check for 580 {late registralion pryable to nisil to6 Adeh il*drob {Attn: ScYs* *rrySsarf 12O Patty tefie, sloretrc, Xy. rttoit2

BCYSA

Family discount: A family of 3 registered players, $5 off per player. A family with 4 registered players, the 4th player is free.

Those interested in volunteering to head coach in the BCYSA must fill out a Coaching lnterest Form

F