Lindon City Youth Spring Soccer
Lindon City Youth Spring Soccer Lindon City offers a Short Sided Soccer league that provides many benefits, including; more touches on the ball, more shots on goal, more scoring and more fun. The league allows for improved skill development, better utilization of the field and more cardio/activity level. The teams are smaller and rules simplified (no offsides) to allow more participation and time with the coach.
PARTICIPATION FEE: $35.00
SIGN-UP DEADLINE: March 21st
Games will be held on Saturday’s beginning May 3rd and concludes June 7th. Games will be held at Pioneer Park (150 S 500 E, Lindon) TEAM INFORMATION: Teams will be formed based on elementary school boundary. Those wishing to request a friend may request one friend at the time of registration. Please note that requests cannot be guaranteed. TEAM REGISTRATION: If you would like to register as a team, you must register together in person at the Lindon Community Center office. Team registrations require a volunteer coach at the time of registration. A separate registration form must be completed for each player along with payment at the time of registration. Spots will not be held for individuals who do not submit their form and payment at the time of team registration. Teams with fewer than the max. roster will be filled with individual registrations. *AGE CUT OFF DEADLINE: MAY 1ST REGISTER IN THE APPROPRIATE AGE GROUP AS OF MAY 1, 2014. HOW TO REGISTER: You can register on-line at www.lindoncity.org under Parks and Recreation, or fill out form and turn it into the Lindon Community Center (25 N. Main St.) with full payment.
Please mark the league you are registering for: _______ Boys 4-5 yrs. (4v4, max roster of 8)
_______ Girls 4-5 yrs. (4v4, max roster of 8)
_______ Boys 6-7 yrs. (6v6, max roster of 10)
_______ Girls 6-7 yrs. (6v6, max roster of 10)
_______ Boys 8-9 yrs. (6v6, max roster of 10)
_______ Girls 8-9 yrs. (6v6, max roster of 10)
_______ Boys 10-12 yrs. (7v7, max roster of 10)
_______ Girls 10-12 yrs. (7v7, max roster of 10)
T-Shirt Size:
YXS
YS
YM
YL
YXL
S
M
L
XL
XXL
Participants Name:_____________________________________________ Age:________ Date of Birth:________________ School Child Attends/Closest To:_________________________________________________________________________ Full Address: __________________________________________________________________________________________ Best Phone Number:__________________________________ Email:___________________________________________ Emergency Contact:___________________________ Relationship:_________________ Phone:______________________ I would like to be placed on the same teams as (one request):__________________________________________________ *We cannot guarantee request but will make every effort to fulfill your request
Are you Registering as a Team?
YES
NO
If “YES”, Coach’s Name:_______________________________
Volunteer Coaches are a very important asset! We would appreciate it if you would be willing to help coach this year! ________Head Coach (Name):____________________________________________Phone:___________________________ ________ Asst. Coach (Name):____________________________________________Phone:___________________________ Our main source of communication is through e-mail. Please provide your most convenient e-mail if you have volunteered to coach! E-mail:________________________________________________________________________________________________
Parental/ Participant Statement of Agreement Assumption of Risk, Liability Release, Refund Policy, Emergency Treatment and Concussion Policy Please read this form carefully and be aware that by signing this document you will be waiving and releasing all claims for injuries that you, or your dependents, may sustain while participating in activities offered or sponsored by Lindon City’s Division of Parks and Recreation. As the legal guardian of a participant in the Lindon Recreation Program, I hereby acknowledge and understand that participants will be engaged in activities that involve inherent risks up to and including serious injury, permanent disability or death. Intending to be legally bound, I hereby covenant not to sue Lindon City or its employees, agents, servants, or attendees and hereby release, waive, and discharge the same from any and all claims, causes of action and liability arising in any way out of an injury to the participant and from loss of his/her personal property by theft, damage or otherwise while participating in Lindon Recreation Program sponsored or supported events and/or related activities. Refund Policy: The Lindon City Parks and Recreation Department will consider refund requests on an individual basis. Request for refunds before the season starts may be eligible for a full refund. 30 days after the start of the program will not be considered for a refund. Refunds requests older than 15 days from program start may be eligible for a 50% refund. In addition, Lindon City Parks & Recreation retains the right to withhold up to 25% of for administrative costs in all circumstances. Emergency Treatment: I hereby authorize Lindon City Parks & Recreation program staff to act on my behalf in accordance with their best judgment in case of an emergency involving my child, and agree to assume full responsibility for all expenses, medical or otherwise, that may arise therefrom. I understand that I or my insurance company will pay for such emergency treatment. I acknowledge that I have read the Parental/ Participant Statement of Agreement Assumption of Risk, Liability Release, Refund Policy, Emergency Treatment and have received a Concussion disclosure and waiver form its contents and disclosure, that I understand its contents and disclosures, and that I agree to its terms.
CONCUSSION OR TRAUMATIC HEAD INJURY POLICY DISCLOSURE AND WAIVER Pursuant to the Utah Protection of Athletes with Head Injuries Act, (U.C.A. §26-53-101 et. al.) Lindon City adopts the following concussion or traumatic head injury policy for the Lindon Recreation Programs. I understand that the Lindon Recreation Program has adopted and enforces a Concussion Policy consistent with the Utah Protection of Athletes with Head Injuries Act. The Lindon Recreation Program requires the immediate removal of any athlete or participant from a sporting event, including tryouts, practice, sports camps, games, or competitions, if the athlete or participant is suspected of sustaining a concussion or traumatic head injury, with any of the following conditions observed or self-reported that are attributable to the injury: confusion, disorientation or impaired consciousness; dysfunction or memory; loss of consciousness; or other signs of neurological of neuropsychological dysfunction including seizures, irritability, lethargy, vomiting, headache, dizziness, or fatigue. I further understand that the Lindon Recreation Program will not allow an athlete or participant, who has been removed due to a concussion or traumatic head injury, to return to active participation in the program until such athlete or participant has been evaluated by a qualified health care provider who is trained in the evaluation and management of concussions and the Lindon Recreation Program is provided with a written statement from the health care provider stating that within the last three years the care provider has successfully completed training in concussion evaluation and management and that they find that athlete or participant is clear to participate in the sporting activity. I agree to comply with the Lindon Recreation Program’s Concussion Policy and that I will work with the Lindon Recreation Program by not allowing my child/legal ward to participate in Program activities after suffering a concussion or traumatic head injury until they have been cleared as outlined above. I hereby waive any cause of action, right, or claim for damages against Lindon City or its employees, agents, staff, and or volunteers if I allow my child/legal ward to participate in Program activities in violation of this policy. For current information on concussions visit this: http://www.cdc.gov/ConcussionInYouthSports
_________________________________________________________
______________________________________________________
Signature of a parent or legal guardian of participant
Date
_________________________________________________________
_______________________________________________________
Print Name (parent or legal guardian)
Participant’s name (Please Print)
PARTICIPATION FEE: $35.00
SIGN-UP DEADLINE: March 21st
Games will be held on Saturday’s beginning May 3rd and concludes June 7th. Games will be held at Pioneer Park (150 S 500 E, Lindon) TEAM INFORMATION: Teams will be formed based on elementary school boundary. Those wishing to request a friend may request one friend at the time of registration. Please note that requests cannot be guaranteed. TEAM REGISTRATION: If you would like to register as a team, you must register together in person at the Lindon Community Center office. Team registrations require a volunteer coach at the time of registration. A separate registration form must be completed for each player along with payment at the time of registration. Spots will not be held for individuals who do not submit their form and payment at the time of team registration. Teams with fewer than the max. roster will be filled with individual registrations. *AGE CUT OFF DEADLINE: MAY 1ST REGISTER IN THE APPROPRIATE AGE GROUP AS OF MAY 1, 2014. HOW TO REGISTER: You can register on-line at www.lindoncity.org under Parks and Recreation, or fill out form and turn it into the Lindon Community Center (25 N. Main St.) with full payment.
Please mark the league you are registering for: _______ Boys 4-5 yrs. (4v4, max roster of 8)
_______ Girls 4-5 yrs. (4v4, max roster of 8)
_______ Boys 6-7 yrs. (6v6, max roster of 10)
_______ Girls 6-7 yrs. (6v6, max roster of 10)
_______ Boys 8-9 yrs. (6v6, max roster of 10)
_______ Girls 8-9 yrs. (6v6, max roster of 10)
_______ Boys 10-12 yrs. (7v7, max roster of 10)
_______ Girls 10-12 yrs. (7v7, max roster of 10)
T-Shirt Size:
YXS
YS
YM
YL
YXL
S
M
L
XL
XXL
Participants Name:_____________________________________________ Age:________ Date of Birth:________________ School Child Attends/Closest To:_________________________________________________________________________ Full Address: __________________________________________________________________________________________ Best Phone Number:__________________________________ Email:___________________________________________ Emergency Contact:___________________________ Relationship:_________________ Phone:______________________ I would like to be placed on the same teams as (one request):__________________________________________________ *We cannot guarantee request but will make every effort to fulfill your request
Are you Registering as a Team?
YES
NO
If “YES”, Coach’s Name:_______________________________
Volunteer Coaches are a very important asset! We would appreciate it if you would be willing to help coach this year! ________Head Coach (Name):____________________________________________Phone:___________________________ ________ Asst. Coach (Name):____________________________________________Phone:___________________________ Our main source of communication is through e-mail. Please provide your most convenient e-mail if you have volunteered to coach! E-mail:________________________________________________________________________________________________
Parental/ Participant Statement of Agreement Assumption of Risk, Liability Release, Refund Policy, Emergency Treatment and Concussion Policy Please read this form carefully and be aware that by signing this document you will be waiving and releasing all claims for injuries that you, or your dependents, may sustain while participating in activities offered or sponsored by Lindon City’s Division of Parks and Recreation. As the legal guardian of a participant in the Lindon Recreation Program, I hereby acknowledge and understand that participants will be engaged in activities that involve inherent risks up to and including serious injury, permanent disability or death. Intending to be legally bound, I hereby covenant not to sue Lindon City or its employees, agents, servants, or attendees and hereby release, waive, and discharge the same from any and all claims, causes of action and liability arising in any way out of an injury to the participant and from loss of his/her personal property by theft, damage or otherwise while participating in Lindon Recreation Program sponsored or supported events and/or related activities. Refund Policy: The Lindon City Parks and Recreation Department will consider refund requests on an individual basis. Request for refunds before the season starts may be eligible for a full refund. 30 days after the start of the program will not be considered for a refund. Refunds requests older than 15 days from program start may be eligible for a 50% refund. In addition, Lindon City Parks & Recreation retains the right to withhold up to 25% of for administrative costs in all circumstances. Emergency Treatment: I hereby authorize Lindon City Parks & Recreation program staff to act on my behalf in accordance with their best judgment in case of an emergency involving my child, and agree to assume full responsibility for all expenses, medical or otherwise, that may arise therefrom. I understand that I or my insurance company will pay for such emergency treatment. I acknowledge that I have read the Parental/ Participant Statement of Agreement Assumption of Risk, Liability Release, Refund Policy, Emergency Treatment and have received a Concussion disclosure and waiver form its contents and disclosure, that I understand its contents and disclosures, and that I agree to its terms.
CONCUSSION OR TRAUMATIC HEAD INJURY POLICY DISCLOSURE AND WAIVER Pursuant to the Utah Protection of Athletes with Head Injuries Act, (U.C.A. §26-53-101 et. al.) Lindon City adopts the following concussion or traumatic head injury policy for the Lindon Recreation Programs. I understand that the Lindon Recreation Program has adopted and enforces a Concussion Policy consistent with the Utah Protection of Athletes with Head Injuries Act. The Lindon Recreation Program requires the immediate removal of any athlete or participant from a sporting event, including tryouts, practice, sports camps, games, or competitions, if the athlete or participant is suspected of sustaining a concussion or traumatic head injury, with any of the following conditions observed or self-reported that are attributable to the injury: confusion, disorientation or impaired consciousness; dysfunction or memory; loss of consciousness; or other signs of neurological of neuropsychological dysfunction including seizures, irritability, lethargy, vomiting, headache, dizziness, or fatigue. I further understand that the Lindon Recreation Program will not allow an athlete or participant, who has been removed due to a concussion or traumatic head injury, to return to active participation in the program until such athlete or participant has been evaluated by a qualified health care provider who is trained in the evaluation and management of concussions and the Lindon Recreation Program is provided with a written statement from the health care provider stating that within the last three years the care provider has successfully completed training in concussion evaluation and management and that they find that athlete or participant is clear to participate in the sporting activity. I agree to comply with the Lindon Recreation Program’s Concussion Policy and that I will work with the Lindon Recreation Program by not allowing my child/legal ward to participate in Program activities after suffering a concussion or traumatic head injury until they have been cleared as outlined above. I hereby waive any cause of action, right, or claim for damages against Lindon City or its employees, agents, staff, and or volunteers if I allow my child/legal ward to participate in Program activities in violation of this policy. For current information on concussions visit this: http://www.cdc.gov/ConcussionInYouthSports
_________________________________________________________
______________________________________________________
Signature of a parent or legal guardian of participant
Date
_________________________________________________________
_______________________________________________________
Print Name (parent or legal guardian)
Participant’s name (Please Print)
