Beaver Youth Soccer Association

BEAVER YOUTH SOCCER ASSOCIATION

Spring 2018 Registration

Last Name: ______First: ______M.I.______

Birth date: ______M or F School: ______Grade: ___

Parents: ______Phone#:______

Address: ______

City: ______State______Zip: ______

Email Address: ______

Shirt Size: YS (6-8) YM (10-12) YL (14-16) AS AM AL AXL

My players’ skill level is: □ Beginner □ Intermediate □ Advanced Competitive

You are required to wear black shorts and black socks for games, shin guards are required and must be worn UNDER socks. If you are unable to make it to a practice or a game, you are required to call your coach to let them know. U6 and up are required to wear OUTDOOR SOCCER CLEATS.

Please list any information concerning the player’s medical history (including allergies, medications being taken, and physical impairments):

FIRST CONTACT: ______PHONE#:______

SECOND CONTACT: ______PHONE#:______

Please circle if you would like to volunteer to help with any of the following:

COACH ASST.COACH CONCESSION STAND FIELD MAINTENANCE TEAM PARENT (organizing snacks for after games, etc.)

CONSENT FOR MEDICAL TREATMENT

As the parent or legal guardian of the above player, I hereby give consent for emergency medical care prescribed by a duly-licensed doctor of medicine or doctor of dentistry. This care may be given under whatever conditions are necessary to preserve life, limb, or wellbeing of my dependent.

Parent/Guardian:______Phone:______

I, Parent/Guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the USYSA, and its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration of the USYSA accepting the registrant for its soccer programs and activities (the programs), I hereby release, discharge, and/or otherwise indemnify the USYSA, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of the fields and facilities utilized for the programs against any claim by or on behalf of the registrant as a result of the registrant’s participation in the program and/or being transported to or from the same which transportation I hereby authorize.

Parent/Guardian______

A non-refundable registration fee of $65 is due with this completed form by March 1, 2018.If you complete 3 volunteer shifts, you will be refunded $20 at the end of the season.Sibling discount applies after first child: 1st child $65.00, 2nd child $40.00, 3rd child $35.00 etc. Deadline is March 1, 2018.

DO NOT REQUEST COACHES. **IMPORTANT your practices (U6 and up)could be ANY 2 days M-TH and are dependent upon the coaches’ availability, this is a RANDOM draft,games will be played M-TH, Saturdays and possibly Sunday depending on ref availability. Practices are generally 6pm-7:30pm. U3/U4 Practice and Games M/W 6-7. There will be NO switching teams/days, if you have multiple children you may be there 4-5 days per week.In order to keep our random draft fair for everyone we are unable to honor requests of any kind. Player age groups are determined by birthdate prior to the Fall season and may differ from the age group previously played.

Make check or M.O. (There will be a $10 returned check fee) payable to: --- BEAVER YOUTH SOCCER ASSOCIATION. ---- P.O. Box 2792 --- East Liverpool, Ohio 43920

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Online registration available through our website

Questions Call/Text Misty Mays 330-708-3020NEW EMAIL ADDRESS