2017-2018Recreational Registration Form

2017-2018Recreational Registration Form

Fall 2017 and Spring 2018

FEES: $80 for recreational U6 player

$90 for each recreational U8 player

$100 for each U10 player

$120 for each U12 and above player for a full year

$100 for each U12 and above player for half a year (one season Fall or Spring)

All applicants returned later than June 15, must include a $25 late fee per child and aren’t guaranteed team placement!

Fees include the entire Soccer Year of August 1 through July 31 and include shirt, shorts and socks, secondary insurance and Louisiana Soccer Association, USYSA AND USSF registration fees*Required player-furnished equipment for all ages: soccer approved shoes (round studs, no toe cleat), approved shorts and shin guards!*

U8 and above will be Gender Specific for Fall and Spring League

Division Requested for 2015-16 (check one): RacelandLarose

Child’s Name: LAST: ______FIRST: ______INITIAL: ______SEX: Male Female

Date of Birth: ______

Mailing Address: ______City: ______Zip Code: ______

Phone Number: ______Cell Number: ______e-Mail: ______

Father’s Name: ______Mother’s Name:______
Check this Box if some of your information changed from pervious registration year (i.e. email, address)

OUR CLUB SUGGESTS THAT ALL PARTICIPANTS TAKE A COMPLETE PHYSICAL BEFORE PARTICIPATING

I, THE PARENT/GUARDIAN OF THE REGISTRANT, AGREE THAT THE REGISTRANT AND I WILL ABIDE BY THE RULES OF THIS LEAGUE, THE LOUISIANA SOCCER ASSOCIATION, (LSA) AND THE UNITED STATES SOCCER FEDERATION (USSF) AND ITS AFFILIATE ORGANIZATIONS, RECOGNIZING THE POSSIBILITY OF PHYSICAL INJURY ASSOCIATED WITH SOCCER AND IN CONSIDERATION FOR THE REGISTRANT BEING ACCEPTED AS A PARTICIPANT IN THIS SOCCER PROGRAM, I HEREBY RELEASE, HOLD HARMLESS, AND AGREE TO INDEMNIFY THIS LEAGUE, THE LSA, THE USSF AND THEIR AFFILIATED ORGANIZATIONS AND ALL PERSONS, OFFICERS, REFEREES, COACHES AND OFFICIALS, INCLUDING THE OWNERS OF FIELDS AND FACILITIES USED FOR THE PROGRAMS FROM ANY AND ALL LIABILITY OF EVERY NATURE, KIND AND DESCRIPTION AS A RESULT OF ANY INJURIES, HURT OR DAMAGE SUSTAINED BY A REGISTRANT AS A RESULT OF HIS/HER PARTICIPATION IN THIS SOCCER PROGRAM AND/OR BEING TRANSPORTED TO OR FROM THE SAME. I ALSO GRANT PERMISSION TO MANAGING PERSONNEL, COACHES OR OTHER LEAGUE REPRESENTATIVES TO AUTHORIZE AND OBTAIN MEDICAL CARE FROM ANY LICENSED PHYSICIAN, HOSPITAL, OR MEDICAL CLINIC SHOULD THE REGISTRANT BECOME ILL OR INJURED WHILE PARTICIPATING IN LEAGUE ACTIVITIES AWAY FROM HOME OR AT OTHER TIMES WHEN NEITHER PARENT/GUARDIAN IS AVAILABLE TO GRANT AUTHORIZATION FOR EMERGENCY TREATMENT.

Signature: ______Date:______

PARENT/GUARDIAN