2009 YMCA INDOOR SOCCER INSTRUCTIONAL
PROGRAM AT WEST HILLS ELEMENTARY
Season: September 30th — November 16th
Instructor: Allan Muyskens, Youth Sports Instructor
Cost: $40 for YMCA Members and $55 for Non-Members
Registration deadline is Saturday, September 26th
Cost Includes: Team shirt & End of season award
In this exciting 7 week program (12 practice sessions), everyone
is a winner. Everyone participates and has fun in a safe and
positive non-competitive environment. Your child will learn
new soccer skills or improve his or her current skill level. This instructional program provides
children an excellent introduction to team sports through maximum ball contact, positive instruc-
tion, and small sided games. Players will learn the soccer fundamentals of dribbling, passing,
shooting, and offensive and defensive team play; and also the rules of the game. And above all
“FUN” is our focus.
CARING HONESTY RESPECT RESPONSIBILITY
1st through Practices held on Mondays and Wednesdays at Westhills Elementary.
4th Grade Time 5:15p.m.- 6:15p.m. Limited to the first 15 players to register.
Girls Practices held on Mondays and Wednesdays at Westhills Elementary.
1st through Time 6:30p.m.– 7:30p.m. Limited to the first 15 players to register.
Children should wear shorts or sweat pants, sneakers and a t-shirt to practice.
Shin guards are mandatory and are not supplied.
To Register: Fill out form completely (front and back), and drop off payment and form at YMCA or mail to: YMCA
Youth Sports, 60 Magnuson Way, Bremerton WA 98310. For more information call the YMCA at (360) 377-3741
Program Title__________________________________Age_________Child’s Date of Birth_________________
(10-12) (14-16) (18-20)
Shirt size: Child(C) CM____ CL____ CXL____ Adult (A) AS____ AM____
office use only
RCT # _______________
Home Phone_____________________Work Phone______________
Medical Insurance Company______________________________Policy Number_________________
Restriction and Limitations (Medications, Allergies, Injuries, Etc.)
Note: The YMCA does not take any responsibility for children before and after the Youth Sports programs. YMCA staff
will leave the program sites when the program ends. Make sure you are present to pick your child up.
YMCA MISSION STATEMENT
To put Christian principles into practice through programs that build
healthy body, mind, and spirit for all.
The Youth Sports program is based on participation and not
competition. We believe that everyone gets to play and that winning is not
everything but learning how to play is. Our programs encourage fun, skill
development, fitness, team work, fair play, character development, and family
involvement. We want youngsters going away feeling good about themselves.
SCHOLARSHIPS: Forms are available at the YMCA front desk.
I give permission for my child to participate in the above listed YMCA program, and I give
permission for the YMCA to use any pictures of my child for future promotional purpose.
I hereby authorize the YMCA staff to act for me according to their best judgment in any
emergency requiring medical attention and I hereby waive and release the YMCA and its staff
from any and all liability for any injuries or loss damages that result from participation in any
YMCA program. This waiver expressly includes transportation to and from and in connection
with said program, in any vehicle operated by its staff.
The YMCA youth sports program reserves the right to cancel or re-schedule any of its programs.
In this case, prorated refunds will automatically be issued as follows: 100% refund before
programs begin, and 80% refund through the first week of program (if a week long program, an
80% refund will be issued through the first day). No refund after first week (or day if in a week