fall 2016 rec soccer registration form
FALL 2016 REC SOCCER REGISTRATION FORM Live Registration: Thursday, April 21st, 4:30-6:30 PM at the Habig Center or mail to: Jasper Youth Soccer P.O. Box 673 Jasper, IN 47547-0673
Online Registration: sports.bluesombrero.com/jys Online registration is encouraged
& max family discount will apply! Deadline: June 1, 2016
1. General Information: (Please fill out a separate form for each child in the family) Child’s Name: ____________________________________________________________ Age:__________ Gender: M
F
Birth (mm/dd/yy): ______ /______ / ______ (Must be 4 - 12 yrs. old before August 1st, 2016) Address: ___________________________________________________________________________ Zip:_______________________
Pre-K School:______________________________________ Grade entering this Fall: ______________ Any medical conditions? _______________________________________________________________________________________ Played last Fall rec season? Y
/ N
0 Years played? ___________
Did the child play on a Spring soccer travel team? Y / N
Participated in Academy? Y
/N
0 How many seasons? ________________
A T-shirt is included with registration size (circle one) YS YM YL AS AM AL Parent/Guardian #1 Name:_____________________________________________________________________________________ Phone: (_________)___________________________ Email Address:____________________________________________________ Parent/Guardian #2 Name:_____________________________________________________________________________________ Phone: (_________)___________________________ Email Address:____________________________________________________ 2. As a Not-For-Profit Organization we rely heavily on parents to volunteer in the following ways: Board Member Coach Assistant Coach Field Help Volunteer Name: _________________________________________________________ Phone: (_________)___________________________ Email Address:____________________________________________________ Note: Games may be played any day of the week, but mainly on Sundays and one Saturday. 3. Waiver (MUST BE SIGNED) _____________________________________________________________________ I hereby for myself, my minor child, my administrators, heirs and assigns waive and release any and all right and claims for damages, including negligence, I may have against Jasper Youth Soccer, Inc., its board of directors, commissioners, chairpersons, referees, and/or coaches, and the City of Jasper, its boards, elected and appointed officials, and its employees, for property damage or personal injury, including death that may arise or grow out of my minor child’s participation in the Association’s Soccer Program. I also agree to indemnify and hold harmless Jasper Youth Soccer, Inc.; its board of directors, commissioners, chairpersons, referees, and/or coaches and the City of Jasper, its boards, elected and appointed officials, and its employees in any claim, damages, expenses or action, including attorney fees, assessed or brought against them because of my acts or omissions or the acts or omissions of my minor child. I give JYSA permission to use photographic images of my child for website and advertising purposes.
4. Payment Information:
Registration Fee: $40 per player ($100 max per family) $________________ Park & Recreation non resident* fee: $10 per player $________________ *If you do not get Jasper trash pick-up service, you have non-resident status. Total amount $________________ If you do not live within the city limits of Jasper but own property here, please include address: _________________________________________________________________
JYS Representative Use Only: Age Division (This player): ________________ Girls / Boys Cash received $____________ Check received (payable to “Jasper Youth Soccer”) $______________ If check is for multiple applicants, list player names: ______________________________________________________________ Date received: ______/_______/2016 Received by: ______________________________________________________________
JASPER YOUTH SOCCER Email: [email protected] Website: sports.bluesombrero.com/jys Facebook: facebook.com/jasperindianayouthsoccer Location : Schroeder Soccer Complex, 400 West 2nd St, Jasper IN Team Assignment Notification & Waiting Lists: Guaranteed registration if registration form is received and paid by June 1st. Any registrations received after June 1st will be placed on a wait list. All players and coaches should attend the meeting for their division on July 18th or 19th (see times below). Team assignments will be distributed during this meeting. Please notify the league if you are unable to attend the meeting by emailing [email protected] or by contacting Wayne Nealy at 812-272-7361.
Season Information: Registration Deadline:
June 1st
Background Check Due:
July 1st
Coach & Player Meeting : U6: July 18th 5:45-6:45 (Coaches start at 5:30)
U10: July 18th 7:15-8:15 (Coaches start at 7:00)
U8: July 19th 5:45-6:45 (Coaches start at 5:30)
U12: July 19th 7:15-8:15 (Coaches start at 7:00)
First week of practices:
August 8th
Coaches Clinic:
August 13th & 14th (time TBD)
** Optional clinic facilitated by the Director of Soccer Education from our state organization, Indiana Soccer. Season begins:
August 28th
Team Pictures:
September 18th & 25th (tentative)
Final games:
October 16th
Volunteer Information: Volunteer coaches will receive an email with instructions to complete an online background check with Indiana Soccer. The background check is required by Indiana Soccer. Contact [email protected] or Wayne Nealy at 812-272-7361 if you have any questions or do not receive an email by June 1st.
Coaches Clinic: August 13th & 14th Jasper Youth Soccer is hosting an E-License course free of charge to all current and future coaches. This 2 day course gives every coach a working knowledge of basic coaching skills and allows coaches a hands on training on Sunday. JYS strongly encourages all coaches to consider taking advantage of this great entry level coaching course! Registration and more information will be available online here: http://www.soccerindiana.org/education/coaching_courses_calendar.aspx
Online Registration: sports.bluesombrero.com/jys Online registration is encouraged
& max family discount will apply! Deadline: June 1, 2016
1. General Information: (Please fill out a separate form for each child in the family) Child’s Name: ____________________________________________________________ Age:__________ Gender: M
F
Birth (mm/dd/yy): ______ /______ / ______ (Must be 4 - 12 yrs. old before August 1st, 2016) Address: ___________________________________________________________________________ Zip:_______________________
Pre-K School:______________________________________ Grade entering this Fall: ______________ Any medical conditions? _______________________________________________________________________________________ Played last Fall rec season? Y
/ N
0 Years played? ___________
Did the child play on a Spring soccer travel team? Y / N
Participated in Academy? Y
/N
0 How many seasons? ________________
A T-shirt is included with registration size (circle one) YS YM YL AS AM AL Parent/Guardian #1 Name:_____________________________________________________________________________________ Phone: (_________)___________________________ Email Address:____________________________________________________ Parent/Guardian #2 Name:_____________________________________________________________________________________ Phone: (_________)___________________________ Email Address:____________________________________________________ 2. As a Not-For-Profit Organization we rely heavily on parents to volunteer in the following ways: Board Member Coach Assistant Coach Field Help Volunteer Name: _________________________________________________________ Phone: (_________)___________________________ Email Address:____________________________________________________ Note: Games may be played any day of the week, but mainly on Sundays and one Saturday. 3. Waiver (MUST BE SIGNED) _____________________________________________________________________ I hereby for myself, my minor child, my administrators, heirs and assigns waive and release any and all right and claims for damages, including negligence, I may have against Jasper Youth Soccer, Inc., its board of directors, commissioners, chairpersons, referees, and/or coaches, and the City of Jasper, its boards, elected and appointed officials, and its employees, for property damage or personal injury, including death that may arise or grow out of my minor child’s participation in the Association’s Soccer Program. I also agree to indemnify and hold harmless Jasper Youth Soccer, Inc.; its board of directors, commissioners, chairpersons, referees, and/or coaches and the City of Jasper, its boards, elected and appointed officials, and its employees in any claim, damages, expenses or action, including attorney fees, assessed or brought against them because of my acts or omissions or the acts or omissions of my minor child. I give JYSA permission to use photographic images of my child for website and advertising purposes.
4. Payment Information:
Registration Fee: $40 per player ($100 max per family) $________________ Park & Recreation non resident* fee: $10 per player $________________ *If you do not get Jasper trash pick-up service, you have non-resident status. Total amount $________________ If you do not live within the city limits of Jasper but own property here, please include address: _________________________________________________________________
JYS Representative Use Only: Age Division (This player): ________________ Girls / Boys Cash received $____________ Check received (payable to “Jasper Youth Soccer”) $______________ If check is for multiple applicants, list player names: ______________________________________________________________ Date received: ______/_______/2016 Received by: ______________________________________________________________
JASPER YOUTH SOCCER Email: [email protected] Website: sports.bluesombrero.com/jys Facebook: facebook.com/jasperindianayouthsoccer Location : Schroeder Soccer Complex, 400 West 2nd St, Jasper IN Team Assignment Notification & Waiting Lists: Guaranteed registration if registration form is received and paid by June 1st. Any registrations received after June 1st will be placed on a wait list. All players and coaches should attend the meeting for their division on July 18th or 19th (see times below). Team assignments will be distributed during this meeting. Please notify the league if you are unable to attend the meeting by emailing [email protected] or by contacting Wayne Nealy at 812-272-7361.
Season Information: Registration Deadline:
June 1st
Background Check Due:
July 1st
Coach & Player Meeting : U6: July 18th 5:45-6:45 (Coaches start at 5:30)
U10: July 18th 7:15-8:15 (Coaches start at 7:00)
U8: July 19th 5:45-6:45 (Coaches start at 5:30)
U12: July 19th 7:15-8:15 (Coaches start at 7:00)
First week of practices:
August 8th
Coaches Clinic:
August 13th & 14th (time TBD)
** Optional clinic facilitated by the Director of Soccer Education from our state organization, Indiana Soccer. Season begins:
August 28th
Team Pictures:
September 18th & 25th (tentative)
Final games:
October 16th
Volunteer Information: Volunteer coaches will receive an email with instructions to complete an online background check with Indiana Soccer. The background check is required by Indiana Soccer. Contact [email protected] or Wayne Nealy at 812-272-7361 if you have any questions or do not receive an email by June 1st.
Coaches Clinic: August 13th & 14th Jasper Youth Soccer is hosting an E-License course free of charge to all current and future coaches. This 2 day course gives every coach a working knowledge of basic coaching skills and allows coaches a hands on training on Sunday. JYS strongly encourages all coaches to consider taking advantage of this great entry level coaching course! Registration and more information will be available online here: http://www.soccerindiana.org/education/coaching_courses_calendar.aspx
