Athens First United Methodist Church

Children’s Soccer League

March 18-May 20, 2017

Registration: February 1st – February 28th

Name: ______Age:______D.O.B.______

Grade:______Gender: ______Uniform Size: YXS YS YM YL YXL Church Members: Y N

Mother’s Name & Phone #:______Email:______

Father’s Name & Phone #:______Email:______

Emergency Contact’s Name & Phone #:______

Leagues: Age Control Date: March 1, 2017 Late Registration (after March 1)

Church Member Non-Church Member Late Registration

4 & Under (Co-ed) (3-4 year olds)………………………..…...$65.00 $75______$100.00______

6 & Under (Co-ed) (5-6 year olds) ………………………..…..$65.00 $75______$100.00______

We need volunteer coaches! If you are interested in coaching, please indicate below:

Name: ______Phone #:______Email:______

We are not able to accommodate requests for particular teammates/coaches. Teams will be assigned randomly and balanced for age and gender as much as possible. Thank you for your understanding!

Release of Liability

By signing this Permission/Waiver Form, I expressly assume all risks of my child participating in the activities, whether such risks are known or unknown to me at this time. I further release Athens First United Methodist Church and its ministers, leaders, employees, volunteers, and agents from any claim that my child may have or that I may have against them as a result of injury or illness incurred during the course of participation in the activities. This release of liability shall exclude any gross claims of negligence. This release of liability is also intended to cover all claims that members of the child's or my family or estate, heirs, representatives, or assigns may have against Athens First United Methodist Church or its ministers, leaders, employees, volunteers, or agents.

I further agree to indemnify and hold harmless Athens First United Methodist Church and its ministers, leaders, employees, volunteers, or agents from any and all claims arising from my participation in its activities and programs, or as a result of injury or illness of my child during such activities.

This is a Christian organization and I am expected to conduct myself in accordance with the teaching of Jesus Christ.

Parent/Guardian’s Signature: ______Date:

Athens First United Methodist Church

327 N. Lumpkin St. Athens, GA 30601

Rusty Wood, Recreation Director

706-543-1442 Ext 220

www.athensfirstumc.org |