fall 2017 rec soccer registration form
FALL 2017 REC SOCCER REGISTRATION FORM Live Registration: Thursday, April 20th, 4:30-6:00 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: July 1, 2017
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 years old before August 1st, 2017) Address: ___________________________________________________________________________ Zip:_______________________ School:______________________________________ Grade entering this Fall: ______________ Any medical conditions? _______________________________________________________________________________________ Played last Fall rec season? Y / N Years played? ___________ Did the child play on a Spring soccer travel team? Y / N
Participated in Academy? Y / N 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 are mainly on Sundays. 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 U6 | U8 | U10 | U12 Cash received $____________ Check received (payable to “Jasper Youth Soccer”) $______________ If check is for multiple applicants, list player names: ______________________________________________________________ Date received: ______/_______/2017 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 July 1st. Any registrations received after July 1st will be placed on a wait list. All players and coaches should attend the meeting for their division on August 8th or 10th (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. This year players will be assigned to divisions based on the grade they will be entering in the fall. Minimum age: Must turn 4 years old before 8/1/2017 (birthdate on or before 7/31/2012). Maximum age: Entering 6th grade in Fall 2017. Season Information:
Season Game Schedule:
Registration Deadline:
July 1st
Game 1: 9/17 - Sunday
Background Check Due:
August 3rd
Game 2: 9/24 - Sunday
Coach & Player Meeting : U6: August 8th 6:15-7:15 (Coaches start at 5:45)
Game 3: 10/01 - Sunday
U8: August 10th 6:00-7:00 (Coaches start at 5:45)
Game 4: 10/08 - Sunday
U10 & U12: August 10th 7:15-8:00 (Coaches start at 7:00)
Game 5: Weeknight game
First week of practices:
August 28th
Game 6: 10/15 - Sunday
Season begins:
September 17th
Game 7: Weeknight game
Team Pictures:
October 1st & 8th
Game 8: 10/22 - Sunday
Final games:
October 22nd
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 questions or do not receive an email by July 15th.
Coach/Player Meeting: August 8th & 10th Players: All players need to attend their division meeting. Arrive ready to play (shin guards & cleats). Players will meet their coaches and participate in soccer skills stations. Coaches: All coaches need to attend their division meeting. Division and season details will be discussed and team rosters will be distributed. Coaches will then meet their players and run through a few soccer skills stations with their team.
Download this information sheet or a fillable PDF form here: https://sports.bluesombrero.com/Portals/6185/docs/2017RegistrationForm.pdf
Online Registration: sports.bluesombrero.com/jys Online registration is encouraged
& max family discount will apply! Deadline: July 1, 2017
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 years old before August 1st, 2017) Address: ___________________________________________________________________________ Zip:_______________________ School:______________________________________ Grade entering this Fall: ______________ Any medical conditions? _______________________________________________________________________________________ Played last Fall rec season? Y / N Years played? ___________ Did the child play on a Spring soccer travel team? Y / N
Participated in Academy? Y / N 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 are mainly on Sundays. 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 U6 | U8 | U10 | U12 Cash received $____________ Check received (payable to “Jasper Youth Soccer”) $______________ If check is for multiple applicants, list player names: ______________________________________________________________ Date received: ______/_______/2017 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 July 1st. Any registrations received after July 1st will be placed on a wait list. All players and coaches should attend the meeting for their division on August 8th or 10th (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. This year players will be assigned to divisions based on the grade they will be entering in the fall. Minimum age: Must turn 4 years old before 8/1/2017 (birthdate on or before 7/31/2012). Maximum age: Entering 6th grade in Fall 2017. Season Information:
Season Game Schedule:
Registration Deadline:
July 1st
Game 1: 9/17 - Sunday
Background Check Due:
August 3rd
Game 2: 9/24 - Sunday
Coach & Player Meeting : U6: August 8th 6:15-7:15 (Coaches start at 5:45)
Game 3: 10/01 - Sunday
U8: August 10th 6:00-7:00 (Coaches start at 5:45)
Game 4: 10/08 - Sunday
U10 & U12: August 10th 7:15-8:00 (Coaches start at 7:00)
Game 5: Weeknight game
First week of practices:
August 28th
Game 6: 10/15 - Sunday
Season begins:
September 17th
Game 7: Weeknight game
Team Pictures:
October 1st & 8th
Game 8: 10/22 - Sunday
Final games:
October 22nd
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 questions or do not receive an email by July 15th.
Coach/Player Meeting: August 8th & 10th Players: All players need to attend their division meeting. Arrive ready to play (shin guards & cleats). Players will meet their coaches and participate in soccer skills stations. Coaches: All coaches need to attend their division meeting. Division and season details will be discussed and team rosters will be distributed. Coaches will then meet their players and run through a few soccer skills stations with their team.
Download this information sheet or a fillable PDF form here: https://sports.bluesombrero.com/Portals/6185/docs/2017RegistrationForm.pdf
