fall 2018 rec soccer registration form
FALL 2018 REC SOCCER REGISTRATION FORM Live Registration: JHS Community Room Thursday, April 26th 4:30-6:30 PM
Mail-in Registration: Jasper Youth Soccer P.O. Box, 673 Jasper, IN 47547-0673
Online Registration: sports.bluesombrero.com/jys Online registration is encouraged DEADLINE: June 1st, 2018
1. General Information: (Please complete a separate form for each child in the family)
(Must be 4 years old before August 1st, 2018)
Player Name:_______________________________________ Age:______ Gender: M | F
Birthdate (mm/dd/yy): _____/_____/_____
Address:______________________________________________________ City:____________________________ Zip:_________________ *If you do not live within Jasper city limits, but own property there, include the address:______________________________________________________ (If Jasper city trash pick-up service is unavailable, you have non-resident status)
School this Fall:______________________________________ Grade entering this Fall:________ Shirt Size: YS | YM | YL | AS | AM | AL Any medical conditions?_____________________________________________________________________________________________ Played last season? Y | N Years played:____ Participated in Academy Clinic? Y | N Played Travel Soccer? Y | N Years played:____ Parent/Guardian #1 Name:____________________________________________________________________________________________ Phone: _______________________________ Email Address:________________________________________________________________ Parent/Guardian #2 Name:____________________________________________________________________________________________ Phone: _______________________________ Email Address:________________________________________________________________ 2. Volunteer Information: As a Not-For-Profit Organization we rely heavily on parents to volunteer in the following ways:
□ Coach
□ Assistant Coach
□ Field Lining
□ Board Member
Volunteer Name:_____________________________________________________ Relationship to player:___________________________ Phone: ____________________________ Email Address:___________________________________________________________________ Comments/Special Requests:__________________________________________________________________________________________ 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. Fundraiser Option: New! This year we will offer a discount card for players to purchase and sell to earn free registration, provide a college incentive for your child and help JYS fund future soccer projects. Cards are $15 each. Purchase 7 cards to sell for $105 and receive a free individual registration ($40 value) or purchase 17 cards to sell for $255 and receive free family registration ($100 value). Cards will be available for pickup on July 21st at Schroeder Soccer Complex and at the start of the Fall Rec season. The cards will be good from 8/1/18 until 7/31/2019 and can be used as many times as you would like for the entire year (this is not a peeler card!). Additional benefits and details on the savings card program are available on the attached sheet and our website. 5. Payment Information:
Registration Fee: $40 per player (max of $100 family) $__________
(If Jasper city trash pick-up service is unavailable, you have non-resident status) Park & Rec non-resident fee: $10 per player $__________
(optional) Fundraiser cards requested: $15 per card #_____ $__________ Total amount $__________
JYS Representative Use Only: Age Division (This player): Girls | Boys
U6 | U8 | U10 | U12
NOTES:__________________________________________________
□ Cash $____________ □ Check (payable to “Jasper Youth Soccer”) $_____________ Check#______________ If check is for multiple applicants, list player names:________________________________________________________________________ Received:_____/_____/2018 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 form is received and paid by June 1st. Registrations received after June 1st are placed on a wait list. Players are assigned to divisions based on the grade they will be entering in the fall. Minimum age: Must turn 4 years old before 8/1/2018 (birthdate on or before 7/31/2014). Maximum age: Entering 6th grade in Fall 2018. Team information and discount cards will be available for pickup at Schroeder Soccer Complex from 9:00am to 10:00am on July 21st. Season Information: Registration Deadline: Coaches Clinic: Coaches Meeting: Background Check Due: First practice week: Season begins: Team Pictures: Final games:
June 1st July 21st July 21st August 1st August 13th September 4th September 16th & 23rd October 14th
Season Game Schedule: Game 1: 9/4 - Weeknight game Game 2: 9/10 - Weeknight game Game 3: 9/16 - Sunday Game 4: 9/23 - Sunday Game 5: 9/30 - Sunday Game 6: 10/1 - Weeknight game Game 7: 10/7 - Sunday Game 8: 10/14 - Sunday Rain Makeups: 10/8, 10/9, 10/11
Coaches Meeting: All coaches will be notified via email by July 1st and should attend the coaches meeting at 9:00am on July 21st at Schroeder Soccer Complex. Team assignments and division information 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. Volunteer coaches will receive an email with instructions to complete an online background check with Indiana Soccer. A new background check is required every 2 years by Indiana Soccer. Coaches Clinic: This year Indiana Soccer will be conducting the Grass Roots Soccer course at 9:30am on July 21st at Schroeder Soccer Complex. This course is free to all coaches and is appropriate for all experience levels. Please consider joining us for this fun event! New savings card opportunity: New! This year we will offer a discount card for players to purchase and sell to earn free registration, provide a college incentive for your child and help JYS fund future soccer projects. We have partnered with Great American Savings Card to offer an exclusive $15 ongoing discount card that has the potential to provide $1,000 or $2,500 worth of college scholarship to many colleges across the state and country. A list of these colleges and additional information is available on the JYS website. Your child can take advantage of this scholarship every year until his/her Junior year providing a scholarship up to 25% of his total tuition costs. Cards are $15 each. Purchase 7 cards to sell for $105 and receive a free individual registration ($40 value) or purchase 17 cards to sell for $255 and receive free family registration ($100 value). Cards can also be purchased individually and will be available for pickup July 21st at Schroeder Soccer Complex and at the start of the Fall Rec season. The cards will be good from 8/1/18 until 7/31/2019 and can be used as many times as you would like for the entire year (this is not a peeler card!).
Download this information sheet registration form here: https://sports.bluesombrero.com/Portals/6185/docs/2018 Registration Form.pdf
Mail-in Registration: Jasper Youth Soccer P.O. Box, 673 Jasper, IN 47547-0673
Online Registration: sports.bluesombrero.com/jys Online registration is encouraged DEADLINE: June 1st, 2018
1. General Information: (Please complete a separate form for each child in the family)
(Must be 4 years old before August 1st, 2018)
Player Name:_______________________________________ Age:______ Gender: M | F
Birthdate (mm/dd/yy): _____/_____/_____
Address:______________________________________________________ City:____________________________ Zip:_________________ *If you do not live within Jasper city limits, but own property there, include the address:______________________________________________________ (If Jasper city trash pick-up service is unavailable, you have non-resident status)
School this Fall:______________________________________ Grade entering this Fall:________ Shirt Size: YS | YM | YL | AS | AM | AL Any medical conditions?_____________________________________________________________________________________________ Played last season? Y | N Years played:____ Participated in Academy Clinic? Y | N Played Travel Soccer? Y | N Years played:____ Parent/Guardian #1 Name:____________________________________________________________________________________________ Phone: _______________________________ Email Address:________________________________________________________________ Parent/Guardian #2 Name:____________________________________________________________________________________________ Phone: _______________________________ Email Address:________________________________________________________________ 2. Volunteer Information: As a Not-For-Profit Organization we rely heavily on parents to volunteer in the following ways:
□ Coach
□ Assistant Coach
□ Field Lining
□ Board Member
Volunteer Name:_____________________________________________________ Relationship to player:___________________________ Phone: ____________________________ Email Address:___________________________________________________________________ Comments/Special Requests:__________________________________________________________________________________________ 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. Fundraiser Option: New! This year we will offer a discount card for players to purchase and sell to earn free registration, provide a college incentive for your child and help JYS fund future soccer projects. Cards are $15 each. Purchase 7 cards to sell for $105 and receive a free individual registration ($40 value) or purchase 17 cards to sell for $255 and receive free family registration ($100 value). Cards will be available for pickup on July 21st at Schroeder Soccer Complex and at the start of the Fall Rec season. The cards will be good from 8/1/18 until 7/31/2019 and can be used as many times as you would like for the entire year (this is not a peeler card!). Additional benefits and details on the savings card program are available on the attached sheet and our website. 5. Payment Information:
Registration Fee: $40 per player (max of $100 family) $__________
(If Jasper city trash pick-up service is unavailable, you have non-resident status) Park & Rec non-resident fee: $10 per player $__________
(optional) Fundraiser cards requested: $15 per card #_____ $__________ Total amount $__________
JYS Representative Use Only: Age Division (This player): Girls | Boys
U6 | U8 | U10 | U12
NOTES:__________________________________________________
□ Cash $____________ □ Check (payable to “Jasper Youth Soccer”) $_____________ Check#______________ If check is for multiple applicants, list player names:________________________________________________________________________ Received:_____/_____/2018 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 form is received and paid by June 1st. Registrations received after June 1st are placed on a wait list. Players are assigned to divisions based on the grade they will be entering in the fall. Minimum age: Must turn 4 years old before 8/1/2018 (birthdate on or before 7/31/2014). Maximum age: Entering 6th grade in Fall 2018. Team information and discount cards will be available for pickup at Schroeder Soccer Complex from 9:00am to 10:00am on July 21st. Season Information: Registration Deadline: Coaches Clinic: Coaches Meeting: Background Check Due: First practice week: Season begins: Team Pictures: Final games:
June 1st July 21st July 21st August 1st August 13th September 4th September 16th & 23rd October 14th
Season Game Schedule: Game 1: 9/4 - Weeknight game Game 2: 9/10 - Weeknight game Game 3: 9/16 - Sunday Game 4: 9/23 - Sunday Game 5: 9/30 - Sunday Game 6: 10/1 - Weeknight game Game 7: 10/7 - Sunday Game 8: 10/14 - Sunday Rain Makeups: 10/8, 10/9, 10/11
Coaches Meeting: All coaches will be notified via email by July 1st and should attend the coaches meeting at 9:00am on July 21st at Schroeder Soccer Complex. Team assignments and division information 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. Volunteer coaches will receive an email with instructions to complete an online background check with Indiana Soccer. A new background check is required every 2 years by Indiana Soccer. Coaches Clinic: This year Indiana Soccer will be conducting the Grass Roots Soccer course at 9:30am on July 21st at Schroeder Soccer Complex. This course is free to all coaches and is appropriate for all experience levels. Please consider joining us for this fun event! New savings card opportunity: New! This year we will offer a discount card for players to purchase and sell to earn free registration, provide a college incentive for your child and help JYS fund future soccer projects. We have partnered with Great American Savings Card to offer an exclusive $15 ongoing discount card that has the potential to provide $1,000 or $2,500 worth of college scholarship to many colleges across the state and country. A list of these colleges and additional information is available on the JYS website. Your child can take advantage of this scholarship every year until his/her Junior year providing a scholarship up to 25% of his total tuition costs. Cards are $15 each. Purchase 7 cards to sell for $105 and receive a free individual registration ($40 value) or purchase 17 cards to sell for $255 and receive free family registration ($100 value). Cards can also be purchased individually and will be available for pickup July 21st at Schroeder Soccer Complex and at the start of the Fall Rec season. The cards will be good from 8/1/18 until 7/31/2019 and can be used as many times as you would like for the entire year (this is not a peeler card!).
Download this information sheet registration form here: https://sports.bluesombrero.com/Portals/6185/docs/2018 Registration Form.pdf
