Bremerton Soccer Club Registration Form

Revised: 11/13/2018

Bremerton Soccer Club Registration Form

(360) 377-4408

Mail to: BSC Registrar, PO Box 481, Bremerton, WA98337-0119

New Players must include a copy of a certificate of Live Birth with registration

Returning Players: To be guaranteed a spot on the same team you played on last year, registration forms & payment must be received by June 30th, mail in must be postmarked no later than June 30th. Any registrations received after this date will be on first come, first served basis for team assignment.

Player Registration:

Last Name: ______First Name: ______MI: ______

Address: ______

City: ______State: ______Zip Code: ______

Email Address: ______Home Phone: ______

Birth date (month/day/year): ______Age: ______Circle One: M F

Last Session with BSC: ______Coach Last Season: ______

Mother / Guardian: ______Work Phone: ______Cell: ______

Father / Guardian: ______Work Phone: ______Cell: ______

Emergency Contact: ______Phone: ______Relation to player: ______

Doctor: ______Phone: ______Insurance: ______

Medical Problems, Conditions, and Allergies: ______

Registration fee are as follows:

May 1ST– June 30TH $75.00 (U5-U11) per player or $90.00 (U12-U18)or per player and Family Discount $225.00 (3+ players)

As of July 1ST(late fee added):95.00 (U5-U11) per player or $110.00 (U12-U18) per player and Family Discount $225.00 (3+)

Registrations fees help keep the club going by paying for fields (rental, prepping and maintenance), uniforms, etc. Of the registration fee all is refundable except $10.00 for processing fee. Please make check to: BSC

NOTE: FEES MUST ACCOMPANY THE REGISRTATION FORM (S); PLAYER WILL NOT BE ROSTERED UNTIL ALL FEES ARE COLLECTED.

I, the parent/guardian of the registrant, a minor, do hereby grant permission for the above player to participate in Bremerton soccer and do agree that I and the registrant will abide by the rules of the league, Kitsap Peninsula Youth Soccer Association and the Bremerton Soccer Club including the player and parent/guardian “Code of Conduct” (SEE: I hereby release, discharge and otherwise indemnify the United States Youth Soccer Association (USYSA), its affiliates organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilize for the programs, against any claim by or on behalf of the registrant as a result of the registrant’s participation on the programs and/or being transported to or from the same, which transportation I herby authorize.

Signature of Parent / Guardian: ______Date: ______

These positions are currently vacant or need support. If you are interested in any of these please circle Board Member on the front of registration and the Present of the Club will contact you with further information. You must be able to attend Board Meetings held once a month on the first Thursday after the first Tuesday. All Board Member position is volunteer work. Thank you for your interest!!

KPYSA Club Representative

a. Be responsible for and thoroughly familiar with the

Constitution, Bylaws and Rules and Regulation of the Club

and KPYSA.

b. Be responsible to the Board and Club for ensuring proper

performance of the obligations of the Club to KPYSA.

c. Present Club position on all KPYSA business and policy.

d. Present and promote Club originated proposals to KPYSA.

e. Prepare and present to the KPYSA President a written State of

the Bremerton Soccer Club prior to the KPYSA Annual General

Meeting each season.

f. Provide liaison services between the Club and KPYSA.

g. Attend all KPYSA monthly meetings unless excused by

KPYSA President or replaced by assigned alternate.

h. Assist KPYSA in the promotion of adult interest and

recruitment of desirable persons to assist in the development

of the game of soccer.

Vice President of Fields

a. Obtain permission for use of BremertonSchool District and

Bremerton Parks property for use by the club.

b. Serve on all committees that pertain to BSC future expansion

of Soccer Fields in Bremerton

c. Keep record of field use agreements and monies owed for field

use

d. Serve as Chairperson of the Committee for Field Development

and Maintenance

e. Responsible for readying and maintenance of fields for season

play to include scheduling work parties and assigning club

members to ensure fields are painted prior to every game.

f. Responsible for field use schedules for the club including

coaches schedules for the Annual Coaches Meeting.

g. Appoint assistants as necessary

Web Site Coordinator

a. Create, maintain and keep current in a timely manner the club

web site

b. Attend or serve on any meeting or committee that impacts the

club web site

c. Support the clubs efforts in registration, advertisement and

communication using web technology

d. Keep record of web site polices and procedures

e. Provide support or training as needed

f. Appoint assistants as necessary