Birth Year 2000-2002 / U18
Birth Year2003-2005 / U15
Birth Year 2006-2007 / U12
Birth Year 2008-2009 / U10
Birth Year 2010 / U8
Birth Year 2011 / U7
Birth Year 2012 / U6
Birth Year 2013-2014 / U5
General Information: MSA’s soccer programs give players the opportunity to learn and develop individual and team skills in a non-competitive environment. No scores are recorded, and each player participates in at least 50% of each game. There are referees for the Recreational League teams only. All teams play downsized soccer (i.e., fewer players on the field and smaller fields). This maximizes a player’s opportunities to handle the ball.
Games and Practices: Each team participates in an 8 game season. Players have one practice during the week and one game each Saturday morning. The game sites vary, but all fields are within the South Bend/Mishawaka/Granger area. Due to the fact that teams are formed based upon where players live, the practices will be relatively close to home. The coach decides the day, time, and location for his or her practices. Practices usually occur for 1 hour starting at either 5:30 or 6:30.PM.
Fees: The fees arefor Recreational U5-U8 $100, U10-U18 $125. For Academy U7-U8 $160.00 and U10-U12 $185.00. Jerseys are provided.
Uniforms/Equipment Requirements: All players must wear shin guards and soccer socks for practices and games. For games, players must wear black shorts, black socks, and MSA team Jersey that will be provided. The players are responsible for providing their own shin guards, socks, and shorts. Soccer shoes are recommended but are not required. (Note: Baseball cleats are NOT permitted.) Players are asked to bring their own soccer balls to practices. (Ball Sizes: U5-U7 players - Size 3; U8-U12 players - Size 4; U15 players – Size 5)
Team Formation: MSA attempts to place players from nearby areas together on a team, so we ask that parents complete Step 4 of the registration form as completely and accurately as possible. We will do our best to place all of our participants on a “reasonable” team, but parents must understand that this may not always be their “ideal” choice.
On the registration form, a player may request one other child (of the same gender and in the same age division) to have on his or her team. Any attempts to link more than two players together may result in a denied teammate request. Note: MSA will not honor any individual player’s request for a specific coach.
A head coachmay submit a teammate request of one player other than his/her own child. The head coach’s can also list an assistant coach. The assistant coach can list one player other than their own child. In this way, it is possible to group 4 players total on the same team. Only one assistant coach per team may be involved in this player request scenario. In other words, a maximum of 4 players can be grouped by coach’s requests. Teams can have more than 2 coaches.
Any late registrant, if accepted, will be charged a $30 late fee and will be assigned to a team that still has a roster opening. Thus the assigned team possibly may not be a “neighborhood” team. It may not be possible to honor team mate requests during late registration.
Registration Deadline: March 5,2018
Any forms mailed to MSA must be postmarked on or before Mach 5, 2018.
Any player wanting to register after March 5,2018MUST register ON-LINE at Late registrants will be charged a $30 late fee and will be placed on a waiting list. Players that are not placed on teams will be sent full refunds.
Registration for MSA2018 SpringSeason
ON-LINE Registration is available at .
There is no extra fee for registering on-line, and you can pay by credit card OR debit card.
INSTRUCTIONS: It is imperative that ALL sections of this application be completed.
Incomplete forms will be returned, and registration may be denied.
Step One: Enter Player Information
Player Name: First______Middle______Last______
Birth Date______Gender______School______Grade______
Month and Day of Birth of the Player’s Mother (for example, 08/28 for August 28th): ______
If for any reason this date is not known, please use the date for the father. If neither is known, enter the date for the
player’s day of birth. This information is required by the IYSA to create a unique identification number for the player.
Step Two: Enter Primary Guardian Information
Check Guardian Relationship: □Mother □Father □ Other (Explain: ______)
Guardian Name: First______Last______
Address______City______State_____ Zip Code______
Home Phone______Cell Phone______E-mail*______
*MSA relies heavily upon email communication throughout the season. Please clearly print a valid e-mail address if available.
Step Three: Check the Appropriate Age Division for Player
Instructional League Recreational League
____U5(birth year 2013-2014)____U10(birth year 2008-2009)
____U6(birth year 2012)____U12(birth year 2006-2007)
____U7(birth year 2011)____U15(birth year 2003-2005)
____U8(birth year 2010)____U18 (birth year 2000-2002)
Step Four: Information Needed for Team Formation
The information below is used to increase the likelihood of placing players from nearby areas on the same team.MSA reserves the sole right to make team assignments. Practice sites and practice times are left to the discretion of the coach. NO REFUNDS ARE PERMITTED TO THOSE WHO ARE NOT SATISFIED WITH THEIR TEAM ASSIGNMENTS.
- For carpooling purposes, etc., you may request one player (same gender and age division) with whom to play.
Please check with your requested teammate to make sure he or she is not part of another teammate request.
Note: A head coach may request a group of up to 4 players. A head coach’s request must be made, however, on the volunteer portion of this form. Only head coaches can request a group of 3-4 players.
Requested Teammate’s Name: ______Phone #______
- Check () theTWO locations that arenearest to the registrant’s home:
□ / Clay Park(Auten & Laurel) / □ / Knollwood(Adams & Grape) / □ / Marshall
□ / Tarkington / □ / MSA Park(Cleveland& Beech) / □ / Boehm Park(Edison & Hickory)
Step Five: Calculate Payment Due and Specify Uniform Sizes
Sizes / FeesParticipation Fee: Recreational U5-U8 -$100 Recreational U10-U18-$125
Academy U7-U8 $160 Academy U10-U12 $185
Enter correct fee in the Fees column
If payment is made afterMarch 5,2018, the fee is additional $30 / $ / Mandatory
Shirt Sizes:
Youth Small (YS)- Sz 5-7 Youth Med. (YM) –Sz. 10-12 Youth Large (YL) – Sz. 14-16
Adult Small (AS)
Adult Med. (AM) Adult Large (AL) Adult Extra Large (XL)
Field Development Donation:
The MSA is continually striving to improve the quality of its fields. Any Enter donation amount
donation that you can make towards this effort is greatly appreciated. / $ / Voluntary
TOTAL PAYMENT DUE / $ / TOTAL
Step Six: Have Guardian Sign the Waiver of Claims
By signing below, I agree that the child applying to the Michiana Soccer Association (“MSA”) has my permission to participate in all MSA sanctioned activities (the “MSA Activities”), including but not limited to: practices, games, camps, meetings and all transportation to any and all MSA Activities. As a legal guardian of the child applying to the MSA, I agree to assume for myself and my child all the risks associated with participation in all of the MSA Activities. In the event of any loss, damage or injury to myself or my child arising out of, in connection with, or relating to any MSA Activity, I hereby waive, release and absolve from any and all liability or fault for such loss, damage or injury the following: the MSA, MSA Board, its officers, employees, officials, coaches, sponsors, supervisors, participants and persons transporting any participant. I understand that maintaining insurance for my child for any injuries sustained from participation in MSA Activities is my responsibility. By signing below, I represent that I have legal authority to sign this statement as the legal parent or guardian of the applying child.
Signature of Legal Guardian______Date______
Step Seven: Attach Copy of Birth Certificate (if required)
If this is the player’s first time to participate in the MSA Soccer Program, a copy of the player’s birth certificate must be included with the registration form. Please do not staple it to the application.
Step Eight: Complete OptionalVolunteer CoachForm
Anyone willing to volunteer as a spring season coach should complete the Volunteer Coach Form on the back of this page.
Step Nine: Submit Application and Payment
Make check payable to MSA. Please do not staple check to the application. All requests for refunds must be made in writing. Any returned checks are subject to a $20 service fee.
For Office Use Only
Date Received: ______Check #: ______Check Amt: ______Amt Applied: ______Amt Due: ______
VOLUNTEER COACH FORM
If you wish to coach a team this season, please complete the information below.
Name______Name of child you want to coach: ______
Address ______
(If address is the same as the player’s address on this registration form, write “SAME”.)
Home Phone______Cell Phone______E-mail (Required)______
On what day would you like to practice? (Please circle.) M T W TH F
(circle 1 for U5-U8 and 2 for U10-U18)
What Time would you like practice to start ? (Please circle) 5:30 or 6:30
At what field? ______
If there is someone willing to co-coach your team, please complete the following information:
Co-Coach______Name of child s(he) wants to coach:______
Address______
Home Phone______Cell Phone______E-mail______
Indiana Youth Soccer requires that all MSA volunteers submit to a background check. This simple process requires that volunteers for any position complete a disclosure form on-line. You can access this form via the MSA website at You will NOT be assigned to a team until the disclosure form has been submitted.
Note: Disclosures are valid for two years. If you have coached for MSA in the past, MSA will contact you when it is time to resubmit a form. For more information, visit .
A head coach may request a group one playerother than their own to be placed on his or her team. The coach can also list an assistant coach, who can also request one playerother than their own to be placed on his or her team. By this method, up to 4 kids can be placed on the same team by request. Requests submitted incorrectly will be denied.
Coach’s Teammate Request:
1______2______Player’s Name (Coach’s child if applicable) Player’s Name
3______
Co-Coach’s Name (if applicable)