Sports Emporium Team Roster/Registration Form 2016-2017

Sports Emporium Team Roster/Registration Form 2016-2017

1856 Nimitz Dr.De Pere, WI54115

Phone: (920) 336-1900 Email:

Sport& Bracket ______Session Dates: ______to ______

Team Name______Team Contact Info:Name ______

E-mail Address:______(primary mode of communication)

Home Phone ( ) ______Work Phone ( ) ______Cell Phone ( ) ______

Signature ______Date ______

Player/Parent

Player Name E-mail addressPhone DOB Signature

1.______

2.______

3.______

4.______

5.______

6.______

7.______

8.______

9.______

10.______

11.______

12.______

*Rates: Vary by session length and promptness of payment. Please refer to team fee sheet.

*Roster limit is 12 players for soccer (suit 12 per game), 12 for football (suit 10 per game). No substitution players will be allowed unless authorized by the Sports Emporium. Substitution players must pay a $5.00 fee before playing.

*All team players must wear a matching color that is not white or light gray, AND must bring a white shirt to all scheduled activities. Pinneys will not be provided.

*All players must sign the waiver and payment must be received within the first two weeks of league play. Team contacts are in charge of payment and will be held responsible for any past due payments. Parents must sign for players who have not yet turned 18.

*All players must carry their indoor shoes into the building, and change their shoes before playing.

Waiver:Each player/parent/coach must read and sign the waiver form. Signatures on the registration form signify each person has read, understands, and abides by the information. There are risks associated with player and coach participation in leagues, instruction, camps and tournaments and their related activities. I release, waive, discharge and covenant not to sue the Sports Emporium/DePere Select Soccer Club, Inc., its employees or representatives, sponsors, referees and land owners from all action, suits or demands whatsoever in law or equity of demand, loss or damage on account of injury, including death, caused in whole or part by perceived or determined negligence.

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