SUMMERVILLE CATHOLIC 2016 FallSoccerREGRISTRATION FORM

Anyone wishing to play for a Summerville Catholic team must sign-up through Summerville Catholic. If you are a member of the YMCA, you still must sign-up with Summerville Catholic and not through the YMCA (YMCA membership fee still applies plus uniform fee).

This registration is for playing on a Summerville Catholic team in the YMCASpring soccer season. The cost is $100for each child that are NOT members of the YMCA and $60 for YMCA members (make checks payable to SCS-sports). All SCS students, children of the four supporting parishes can play in accordance with our policy. To register, fill out this form (one per child) and return it to Jean Fox, at the school office by Friday, August 19, 2016.

AGE GROUP: U6 U8 U10 U12 U14

Please select the age group that pertains to your child before August 1, 2016; for example if your child turns 10 beforeAugust 1, 2016 he/she must play on the U12 team.

Uniform Shirt Size (Circle One): YS YM YL AS AM AL AXL

Player’s Name: ______Grade____Age:_____DOB______

Address: ______

Home Phone: ______Cell Phone: ______E-Mail______

Parent(s)/Guardian(s) Name: ______Emergency Contacts:______

Parish attending______School______Active in Religious education______

SPONSORSHIP-if you are interested in sponsoring one of our soccer teams please contact the Athletic Director, Jean Foxat 873-9310 ext.109 or via email:

Company______Contact Name______Phone______

Volunteers: ____Head coach ____Asst. coach ____Team Parent

Medical-please list any concerns such as allergies, handicaps, etc that we should be made aware of:

______

PARENTS AUTHORIZATION

I, the parent/guardian of the above named child, herby give approval to his/her participation in any or all league activities during the current season. I assume all risks and hazards incidental to such participation including transportation to and from all activities and do herby waive, release, absolve, indemnify to hold harmless the parent, local league organization, the school, the organizers, supervisors, participants and persons transporting my child to/from activities for any claim arising out of an injury to him/her except to the extent and in the amount covered by accident or liability insurance held by the local league.

I also grant permission to managing personnel or other league representatives to authorize and obtain medical care from any licensed physician, hospital, or medical clinic, should he/she become ill or injured while participating in league activities or at other times while neither parent is available to grant authorization for emergency treatment.

Parent(s)/Guardian(s) signature: ______

Parent(s)/Guardian(s) Name (printed):______

Parent’s signature, Yes I have read the Athletic Handbook(found on school website):______

Student’s signature, Yes I have read the Athletic Handbook(found on school website):______