FALL YOUTH SOCCER

Welcome to the Northwest Chautauqua Fall Soccer Rec. League!

Teams will be picked by the end of August. You will be contacted by your child’s coach. All practices are played at the NorthLake Family Recreation Center. Games are played either at NorthLake, Smith Field or the Cross Roads Craft and Farm Market.

Leagues —we will have three different leagues.

-Pre-K/Kindergarten -1st-3rd Grades -4th-6th Grades

Equipment needed: Each player is required to supply their own shin guards and socks to cover them. Mouth guards are recommended for all players and athletic cups are suggested for boys. Cleats are not required. For 1st grade and up, cleats are highly recommended.

Fees:

WESTFIELD RESIDENTS: $25.00 for the first child, $20.00 for the second, and $15.00 for the third. ($60 maximum per family) Scholarships are available, if needed.

NON-WESTFIELD RESIDENTS: $40.00 for the first child, $35.00 for the second and $30.00 for the third ($105 maximum per family).

Checks should be made out to: Village of Westfield.

Call 326-4243 for more information or email

TEAR HERE AND KEEP THE UPPER PART OF THIS APPLICATION FOR YOUR RECORDS.

FALL YOUTH SOCCER

Please Print

Player name _____________________________________Birth date________________

Grade_____________ Male___________Female__________

Address__________________________________Phone #______________

Town ___________________________________________

Medical concerns_________________________________________________________

Shirt Size: Youth S M L Adult S M L XL XX

(Circle one)

How did you hear about this program?

Website ___ Newspaper____ Flyers____ A friend___ Other____

I hereby release the Westfield Recreation Commission, the Village of Westfield, NorthLake Family Recreation Center, Cross Roads Craft & Farm Market and all others officially associated with this program from all responsibility regarding injury and/or property damage or loss relating to me, and I authorize medical treatment in case of injury. I give permission to use unnamed photographs for publicity in local media.

Parent’s Signature_____________________________________Date______________