SPRING - 1999
Kickers Youth Soccer League – Spring 2018 Season runs April 14, 2018 to May 19, 2018 Registration deadline to avoid Late Fee is March 16, 2018
Register Online – Youth Soccer League Tab www.KickersSoccerClub.org • • • • • •
Parent-coached practices will be during the week Games are on Saturday mornings at Stuart Sports Complex Please enroll according to the grade the child will be playing in Spring 2018. Please include a copy of the child’s birth certificate for first-time registrants Please read and sign waiver on the second page of this form Please check which grade your child will Email: [email protected] with any questions be playing in. Kinder
1st grade
2nd grade
3rd grade
4th grade
5th/6h grade
7th/8th grade
PLAYER INFORMATION (Please print) Last Name__________________________________________ First _______________________________________ Mailing Address __________________________________________ City __________________ ZIP _____________ Date of Birth ____/____/____
Age: _____
Gender: Male _____ Female_____ Current Grade _____
Nearest Public Elementary School your child attends _________________ Name of school your child attends___________________ Would you prefer your child continue with their previous coach? Yes ____ No _____ Coach Name: _________________________ Additional Comments____________________________________________________________________________ All requests will be attempted to be honored on a first registration received basis. Late player registration subject to availability. PARENT/GUARDIAN CONTACT INFORMATION Name: _______________________Phone #:______________________ Email: ___________________________________________ Name: _______________________Phone #:______________________ Email: ___________________________________________ VOLUNTEER INFORMATION The success of this program depends on volunteer participation. Check one of the following to indicate in which area you prefer to help. **Training will be provided. Head coach _____ Assistant coach _____ There is a $10 Discount for Head Coach; please make sure to email David, [email protected] FEE INFORMATION 1 child $75
2 children $150
3 children $210
4 children $270
Payment Method (circle one) Cash Visa MasterCard Discover Check # __________________________ If Paying by Credit Card Please call the Kickers Soccer Club office at: (630)506-0059 Make checks payable to Kickers Soccer Club Mail registration form and payment to: Kickers SC, 75 Executive Drive, Suite 119, Aurora, IL 60504. Early Registration Fee is $50 per child. Registration form must be post marked by November 14 to receive the early registration discount. All forms must be postdated no later than March 16 to avoid Late Fee! If mailed after March 16 please include $25 Late Fee. Any questions contact David – [email protected] Please Note: There will be a $15 processing fee added to all refunds made. Late fees are non-refundable. PLEASE NOTE YOUR CHILD WILL NOT BE PLACED ON A TEAM UNTIL PAYMENT IS RECEIVED
NOTE: KICKERS SOCCER CLUB WILL NOT ACCEPT THIS DOCUMENT WITHOUT THE SIGNATURE OF THE PARENT OR GUARDIAN ON THE WAIVER. YOUTH SOCCER WAIVER IMPORTANT INFORMATION Kickers Soccer Club is committed to conducting its programs and activities in a safe manner and holds the safety of participants in high regard. Kickers Soccer Club continually strives to reduce risks and insists that all participants follow safety rules and instructions that are designed to protect the participants’ safety. However, participants and parents/guardians of minors registering for this program must recognize that there is an inherent risk of injury when choosing to participate in programs/activities. You are solely responsible for determining if your minor child/ward is physically fit and/or adequately skilled for the activities contemplated by this agreement. It is always advisable—especially if the participant is disabled in any way or recently suffered an illness, injury or impairment—to consult a physician before undertaking any physical activity. WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK Please read this form carefully and be aware that in signing up and participating in this program/activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/activity (including transportation services, when provided). I recognize and acknowledge that there are certain risks of physical injury to participants in this program, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of severity that my minor child/ward or I may sustain as a result of participating in any and all activities connected with or associated with this program/activity. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this program/activity against the Kickers Soccer Club, including its officials, agents, volunteers and employees. I do hereby fully release and forever discharge the Kickers Soccer Club from any and all claims for injuries, damages or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with this program/activity. I have read and fully understand the above information, warning of risk, assumption of risk and waiver and release of all claims. If registering online or via fax, your online or facsimile signature shall substitute for and have the same legal effect as an original form signature. PLEASE PRINT
Participant’s Name __________________________________________________________ Parent/Guardian Signature __________________________________________________________ Date __________________________________________________________ E-mail __________________________________________________________
Participation will be denied if the signature of an adult participant or parent/guardian and date are not on this waiver.
Register Online – Youth Soccer League Tab www.KickersSoccerClub.org • • • • • •
Parent-coached practices will be during the week Games are on Saturday mornings at Stuart Sports Complex Please enroll according to the grade the child will be playing in Spring 2018. Please include a copy of the child’s birth certificate for first-time registrants Please read and sign waiver on the second page of this form Please check which grade your child will Email: [email protected] with any questions be playing in. Kinder
1st grade
2nd grade
3rd grade
4th grade
5th/6h grade
7th/8th grade
PLAYER INFORMATION (Please print) Last Name__________________________________________ First _______________________________________ Mailing Address __________________________________________ City __________________ ZIP _____________ Date of Birth ____/____/____
Age: _____
Gender: Male _____ Female_____ Current Grade _____
Nearest Public Elementary School your child attends _________________ Name of school your child attends___________________ Would you prefer your child continue with their previous coach? Yes ____ No _____ Coach Name: _________________________ Additional Comments____________________________________________________________________________ All requests will be attempted to be honored on a first registration received basis. Late player registration subject to availability. PARENT/GUARDIAN CONTACT INFORMATION Name: _______________________Phone #:______________________ Email: ___________________________________________ Name: _______________________Phone #:______________________ Email: ___________________________________________ VOLUNTEER INFORMATION The success of this program depends on volunteer participation. Check one of the following to indicate in which area you prefer to help. **Training will be provided. Head coach _____ Assistant coach _____ There is a $10 Discount for Head Coach; please make sure to email David, [email protected] FEE INFORMATION 1 child $75
2 children $150
3 children $210
4 children $270
Payment Method (circle one) Cash Visa MasterCard Discover Check # __________________________ If Paying by Credit Card Please call the Kickers Soccer Club office at: (630)506-0059 Make checks payable to Kickers Soccer Club Mail registration form and payment to: Kickers SC, 75 Executive Drive, Suite 119, Aurora, IL 60504. Early Registration Fee is $50 per child. Registration form must be post marked by November 14 to receive the early registration discount. All forms must be postdated no later than March 16 to avoid Late Fee! If mailed after March 16 please include $25 Late Fee. Any questions contact David – [email protected] Please Note: There will be a $15 processing fee added to all refunds made. Late fees are non-refundable. PLEASE NOTE YOUR CHILD WILL NOT BE PLACED ON A TEAM UNTIL PAYMENT IS RECEIVED
NOTE: KICKERS SOCCER CLUB WILL NOT ACCEPT THIS DOCUMENT WITHOUT THE SIGNATURE OF THE PARENT OR GUARDIAN ON THE WAIVER. YOUTH SOCCER WAIVER IMPORTANT INFORMATION Kickers Soccer Club is committed to conducting its programs and activities in a safe manner and holds the safety of participants in high regard. Kickers Soccer Club continually strives to reduce risks and insists that all participants follow safety rules and instructions that are designed to protect the participants’ safety. However, participants and parents/guardians of minors registering for this program must recognize that there is an inherent risk of injury when choosing to participate in programs/activities. You are solely responsible for determining if your minor child/ward is physically fit and/or adequately skilled for the activities contemplated by this agreement. It is always advisable—especially if the participant is disabled in any way or recently suffered an illness, injury or impairment—to consult a physician before undertaking any physical activity. WAIVER AND RELEASE OF ALL CLAIMS AND ASSUMPTION OF RISK Please read this form carefully and be aware that in signing up and participating in this program/activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which you or your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/activity (including transportation services, when provided). I recognize and acknowledge that there are certain risks of physical injury to participants in this program, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of severity that my minor child/ward or I may sustain as a result of participating in any and all activities connected with or associated with this program/activity. I further agree to waive and relinquish all claims I or my minor child/ward may have (or accrue to me or my child/ward) as a result of participating in this program/activity against the Kickers Soccer Club, including its officials, agents, volunteers and employees. I do hereby fully release and forever discharge the Kickers Soccer Club from any and all claims for injuries, damages or loss that my minor child/ward or I may have or which may accrue to me or my minor child/ward and arising out of, connected with, or in any way associated with this program/activity. I have read and fully understand the above information, warning of risk, assumption of risk and waiver and release of all claims. If registering online or via fax, your online or facsimile signature shall substitute for and have the same legal effect as an original form signature. PLEASE PRINT
Participant’s Name __________________________________________________________ Parent/Guardian Signature __________________________________________________________ Date __________________________________________________________ E-mail __________________________________________________________
Participation will be denied if the signature of an adult participant or parent/guardian and date are not on this waiver.
