P.O. Box 5033 De Pere  Wisconsin 54115-5033

Voicemail: 920-785-0203

DE PERE AND LEDGEVIEW TEAMS

WHAT:2015 De Pere and Wrightstown summer youth soccer registration for ages 4-18.

WHO:All youth residing in the De Pere, West De Pere, public and private school districts are eligible to play. Children born between the dates of August 1, 1996 and July 31, 2011 may register. New registrants must provide proof of age: (birth certificate, baptismal certificate or passport– please send only copies if registering by mail.)

HOW:Registration can be done online or by mail.

  1. ONLINE registration at Fee is$40 per child.

Visa and MasterCard accepted only. Due by February 15, 2015.

  1. MAIL IN registration forms and a $45 per child fee. Checks for registration fees must be made payable to DPRYS (one check for registration fees per family). Additional forms can be downloaded from our web site at Please mail completed forms and fees to:DPRYS, P.O. Box 5033, De Pere, WI 54115-5033. Due by January 17, 2015.
  1. WAITING LIST FOR LATE REGISTRANTS Toregister after February 15, 2015see our website: If your child’s age group is full, they will be placed on a waiting list; you will be contacted if/when an opening becomes available. If placed on a team, the cost for registration is $55 per child.

START DATE:The 2015 Season Games will begin the 1st week of June 2015.

The age group nights will be:

4 – 5 Co-Ed (Monday & Wednesday) or 4-5 Co-Ed (Tuesday & Thursday)

6 – 7 Boys (Tuesday & Thursday)6 – 7 Girls (Monday & Wednesday)

8 – 9 Boys (Monday & Wednesday)8 – 9 Girls (Monday & Wednesday)

10 – 11 Boys (Tuesday & Thursday)10 – 11 Girls (Tuesday & Thursday)

All teams 12 and up – games will be held on random nights, Monday through Thursday.

PRACTICES WILL BEGIN IN MAY

Dates and times of practice will be scheduled by the coach.

COACHINGWe will pay fees for coaches to attend clinics. Beginner level to advanced level clinics

CLINICS:are offered. You will be notified of dates for various age group clinics on our website.

SCHEDULES:Yourchild’s schedule and any additional forms will be handed out at the MANDATORY parents’ meetings on Thursday, April23 and Tuesday, April 28 at De Pere High School (East),1700 Chicago St., De Pere

PICTURETeam and individual photos will be taken May18, 19,20, and21.

NIGHTS:More information will be available with the schedule and on our website,

REFUND POLICY: Full refund prior to March 1, 2015. AbsolutelyNO REFUNDS after March 1st.

 Using ONLINE registration saves the DPRYS board a tremendous amount of work.

Please help us by registering online by February 15, 2015

Thank you,

DPRYS Board of Directors


P.O. Box 5033 De Pere  Wisconsin 54115-5033

Voicemail: 920-785-0203

Checklist:

Completed 2015 registration form (1 per child, front and back). MAIL-IN DEADLINE IS 1/17/2015. ONLINE DEADLINE IS 2/15/2015. LATE FEES WILL APPLY STARTING 2/16/2015.

Registration fee ($40 online by 2/15, $45mail-in by 1/17, $55 late). One check per family payable to DPRYS..

New registrant proof of age document (copy of birth certificate, baptismal certificate or passport).

Mail to DPRYS, P.O. Box 5033, De Pere, WI 54115-5033

PLEASE PRINT CLEARLY

Child’s Name ______ Boy  Girl

Street Address ______City ______Zip code______

Primary Phone Number ______

Child’s Birth Date ______Child’s Age as of 7/31/2015 ______

Shirt size: youth small___ youth medium__ youth large___ adult small__ adult medium__ adult large__ adult x large_

Did your child play soccer with DPRYS last summer?  Yes  No

(If No, include a copy of birth certificate, baptismal certificate, passport or clinic card. Registration without proof of age will NOT be accepted). All applicable points on the above checklist must be completed. Failure to do so will result in your registration form being returned and you may miss deadlines.

Father’s Name ______Mother’s Name______

Father’s Phone Number (______)______Mother’s Phone Number (______)______

E-mail Address #1______

E-mail Address #2 ______

I / We hereby agree that the Soccer Association for Youth (SAY), its members, coaches or officers shall not be liable for any injury or loss which my child or children may sustain while participating in activities of any kind whether sponsored by or under the supervision of SAY. And we agree to indemnify and to hold harmless SAY, its members, coaches, officers or designates of any kind from any claim whatsoever.

Parent/Guardian signature ______

In keeping with other organizations’ policies regarding children’s safety and welfare, the national Soccer Association for Youth (SAY) has a policy called “Times Two” which requires that there be two adults present at all team functions.

MEDICAL RELEASE

This form must be completed and signed by parent before the child can practice or play. A second copy of this form will be required by your coach at the first practice.

Player’s Name ______Birth Date: ______

Address: ______Phone: ______

Family Physician: ______Phone: ______

In my absence and an emergency exists, contact: ______

Relationship: ______Phone: ______

Have you had or do you now have any of the following:

Head injury yes  no Fainting spells yes  no

Convulsions/epilepsy yes  no Neck or back injury yes  no

Asthma yes  no High blood pressure yes  no

Diabetes yes  no Kidney problems yes  no

Allergies yes  no Heart murmur yes  no

If yes, briefly describe the problem: ______

______

Is tetanus booster up-to-date? yes  no

Are you currently taking any medications for chronic conditions? If yes, what and why? ______

______

Has your doctor placed any restrictions on your athletic performance? If yes, explain ______

______

Parent’s name(s): ______

Address and phone if different from player: ______