LVS Use Only: Fee paid $_______ Cash_______ Check__________ #__________
Application taken by (initial) _______
Spring Season runs Mid March – Mid May
Cost for all players with jersey’s $60.00 for 1 season, $55.00/per child for 2 children, $45.00/per child for 3 children or more
Cost for all players without jersey’s $80.00 for 1 season, $75.00 per child for 2 children, $70.00 per child for 3 or more children
Player Information Grade in Fall ’07 ______
Last Name ___________________________ First Name ______________________________ Middle Initial ______
Address_______________________________________ City _______________ Zip __________
Primary Phone (_____) - ______ -_____________ Email ____________________________Player’s Birth date ____/____/_____
Person to notify in emergency _________________________ Emergency contact # ____________________
Medical conditions/problems ______________________________________________________________________________
Number of Years Played ___________________ Previous coach ___________________
Primary Contact for this child (Circle One): Mother Father Grandparent Other ________________
Father’s Name ___________________ Email:__________________________ Cell Phone _________________
Mother’s Name ___________________ Email:__________________________ Cell Phone _________________
_____ Coach ____ Assistant Coach
I,________________ (mother/father) _____ Concession help ____ Tournament Helper
am interested in being: _____ Officiating ____ Board Member
Youth Size Adult Size Jersey Color (circle color needed)
Do you need a jersey? Yes No S M L S M L red white blue orange
Do you need shorts? Yes No S M L S M L pink green
I, the undersigned parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of LVS, its affiliated
organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for LVS accepting the
registrant for its soccer programs and activities (the “Programs”). I hereby release, discharge and/or otherwise indemnify LVS, its affiliated
organizations and sponsors their employees associated personnel, including owners of fields and facilities utilized for the Programs, against
any claim by or on behalf of the registrant’s participation in the Programs.
Name __________________________________ Signature ________________________Date_____________
Parent or Legal Guardian (Please Print) Parent or Legal Guardian
I give permission to LVS to use my daughters name or photos to promote the league in the newspaper or the LVS website.
Please circle one: YES or NO
Consent for Medical Treatment (Minor)
As the parent or legal guardian of the above-named player, I hereby give consent for emergency medical care prescribed by a licensed Doctor of Medicine or
Dentistry. Care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent.
Signature of Parent or Guardian ________________________________ Phone: _________________________
Application DEADLINE is February 28, 2008.
Mail Signed Applications and Check to: Lady Viking Soccer (Please make checks payable to Lady Viking Soccer)
P.O. Box 1881, Valparaiso, IN 46384
INFORMATION TO ASSIST IN TEAM SELECTION
We will do our best to accommodate your scheduling and carpooling needs. If this form is not completed, we
assume that your child can practice at any time and has no special considerations for rides, etc.
Player’s Name ______________________________________________________
Days of the week child cannot practice _______________________________________
Share ride with __________________________________________________________
Coaching concerns or special needs of child ___________________________________
Frequently asked questions:
What about uniforms and your uniform policy?
Lady Viking Soccer (LVS) uses 2 jerseys which are provided to girls. When the soccer season ends,
you’ll be required to keep your jersey for the returning season. Replacements can be purchased through
the LVS board. LVS also provides shorts to each girl so they are all uniform. Parent is responsible for lost
or outgrown jerseys and shorts. Shorts are a part of the uniform and must be worn at games. Shorts are
not to be rolled up at the waist to make shorts shorter. Shirts shall be tucked in shorts for all games.
Are fall soccer and spring soccer identical?
The seasons are dictated by the availability of the fields through the Valparaiso Parks Dept. other than
that, the seasons are similar in length and number of games.
When will my child be placed on a team?
Your coach will be calling you and letting you know about practices and game schedules.
What is a modesty clause?
A clause added by some soccer clubs to make sure girls (young women) are covered up and not showing
undergarments or parts of their bodies that should not be showing. This clause is meant for the middle &
high school girls. Girls should have compression shorts and sports bras under their uniforms. Shorts are
not to be rolled up at the waist, to make shorter.
What equipment do I need to purchase?
Your child will need shin-guards, they are mandatory. Middle and High school girls need compression
shorts and sports bras.
Who do I contact if I have questions?
Joe Alessi, League President
(219) 464-8061 email@example.com
Visit our web site at: http://ladyvikingsoccer.org