Recreational League Soccer Registration Bastrop Youth Soccer ...
Recreational League Soccer Registration Bastrop Youth Soccer Organization PO Box 1544, Bastrop, TX 78602 Website: www.BastrooSoccer.om Email:
Write Player's Name exactly as it appears on the birth certificate. Nicknames may be put in parentheses. First:.____________ Middle: ___________ co,,-. _________ Mailing Address:. _______________________City________ Home #:_____________Cell #: ______��-�-=��-W ork#: Unitorm Sz: YXS YS YM y'·L--A-s-- -A-M� Fema e Male Daeo t f B'Irth : a v1 Al PARENT/ GUARDIAN INFORMATION SECTION (Uniform Size Equivalent: YXS = 4T / YS = 5T / YM E-Mail Last Name First Name Father Mother Father's Mailing Address, City & Zip:
Father's Place of Employment I Phone:
I
Mother's Mailing Address, City & Zip: Mother's Place of Employment I Phone:
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I"'-' .1 .. , ... 1'1 I UI d ,,,, ,,._,, : , ,.., d , .... 0.... , 0 ........ , .......... v, LJit: c1uuvi:: 11dmeum1nor, 1 give
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consent for emergency medical care. This care may be given under whatever conditions are necessary to nreserve life. limb or well-bein2' of minor. Date Signature of Parent/Guardian Date Signature of Parent/Guardian u T ..,._,, !!> d vv,...,, '�'-'-'
,..., v, 6(l' ,,za�,011 d!lU VUJU '�"'"'f" 15 I::.,
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volunteer and give my support: __Coaching* __Asst. Coach __Team Parent Board Member* Field Line Strioinl! Stand
-- Concession
*These designated volunteer positions earn a $25 registration credit, redeemable in the next following __ LnecK nere IT you ao not want pictures or your cnua puo11c1zea, 1acK OT response 1mp11es consent.
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Returning players that wish to request same coach. Write coach name here. (NOT
r:1.11.p1ayers... ,v_,_.__enc1ose .....e.ro110.w1ng1 regaru1ess.or. wne ....er ....ey nave ueen prov1aea prev1ous1y, as recoras were destroved in the fire.
(2) Copy of their birth certificate (required by CAYSA) (1) Completed registration form (3) Signed Parent's Code of Ethics form (4) Registration fee payment in full by Check or Credit Card
Registration fee includes pro-rated uniform fee. The same uniform is used for both the Fall and Spring seasons. Only new players or new teams will receive uniforms in the Spring. Deadlines for Spring play: Completed Registration, Parents Code of Ethics Signed Form and Payment in full due upon submittal. If you have a financial assistance please contact [email protected]
Recreational reg1strat1on tee: Ages U4 to U9 1s $1o5 U11-U18 is $125. Late Fees may apply if registration has been closed Muliti child discount of $5 applies st arting with 2nd child (not on 1st child) Make check/Money order Payable to BYSO, Credit Card payments add $5 Credit Card #:
Name as on Card: Exp: Signature of Cardholder: (Amex/front 4 digits. Visa-MC/back, digits) PAYMENT MUST BE INCLUDED WITH REGISTRATION
CCV:
(All checks 1nust have the signer's driver's license nu,nber and date of birth either printed or written on check.) $ Reg/Fund f'r9g, .A
Write Player's Name exactly as it appears on the birth certificate. Nicknames may be put in parentheses. First:.____________ Middle: ___________ co,,-. _________ Mailing Address:. _______________________City________ Home #:_____________Cell #: ______��-�-=��-W ork#: Unitorm Sz: YXS YS YM y'·L--A-s-- -A-M� Fema e Male Daeo t f B'Irth : a v1 Al PARENT/ GUARDIAN INFORMATION SECTION (Uniform Size Equivalent: YXS = 4T / YS = 5T / YM E-Mail Last Name First Name Father Mother Father's Mailing Address, City & Zip:
Father's Place of Employment I Phone:
I
Mother's Mailing Address, City & Zip: Mother's Place of Employment I Phone:
I
" I
I"'-' .1 .. , ... 1'1 I UI d ,,,, ,,._,, : , ,.., d , .... 0.... , 0 ........ , .......... v, LJit: c1uuvi:: 11dmeum1nor, 1 give
'-'"
consent for emergency medical care. This care may be given under whatever conditions are necessary to nreserve life. limb or well-bein2' of minor. Date Signature of Parent/Guardian Date Signature of Parent/Guardian u T ..,._,, !!> d vv,...,, '�'-'-'
,..., v, 6(l' ,,za�,011 d!lU VUJU '�"'"'f" 15 I::.,
,y :,:;:,
.... 011,:;:u VI
t.V 11,:;:1µ, l 1-',c c, t.V
volunteer and give my support: __Coaching* __Asst. Coach __Team Parent Board Member* Field Line Strioinl! Stand
-- Concession
*These designated volunteer positions earn a $25 registration credit, redeemable in the next following __ LnecK nere IT you ao not want pictures or your cnua puo11c1zea, 1acK OT response 1mp11es consent.
-· '"n"
Returning players that wish to request same coach. Write coach name here. (NOT
r:1.11.p1ayers... ,v_,_.__enc1ose .....e.ro110.w1ng1 regaru1ess.or. wne ....er ....ey nave ueen prov1aea prev1ous1y, as recoras were destroved in the fire.
(2) Copy of their birth certificate (required by CAYSA) (1) Completed registration form (3) Signed Parent's Code of Ethics form (4) Registration fee payment in full by Check or Credit Card
Registration fee includes pro-rated uniform fee. The same uniform is used for both the Fall and Spring seasons. Only new players or new teams will receive uniforms in the Spring. Deadlines for Spring play: Completed Registration, Parents Code of Ethics Signed Form and Payment in full due upon submittal. If you have a financial assistance please contact [email protected]
Recreational reg1strat1on tee: Ages U4 to U9 1s $1o5 U11-U18 is $125. Late Fees may apply if registration has been closed Muliti child discount of $5 applies st arting with 2nd child (not on 1st child) Make check/Money order Payable to BYSO, Credit Card payments add $5 Credit Card #:
Name as on Card: Exp: Signature of Cardholder: (Amex/front 4 digits. Visa-MC/back, digits) PAYMENT MUST BE INCLUDED WITH REGISTRATION
CCV:
(All checks 1nust have the signer's driver's license nu,nber and date of birth either printed or written on check.) $ Reg/Fund f'r9g, .A
