Get documents about "Spring 2009 Front
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- 10/5/2012
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Document Sample
1 Form per child PLEASE CHECK
CLOVERLEAF SOCCER ASSOCIATION Rec. Soccer
$10.00 late fee if WWW.CLOVERLEAFSOCCER.COM Travel Soccer(Pending
postmarked after OHIO YOUTH SOCCER ASSOCIATION NORTH Tryout)
Would like to play Rec.
02/10/2012 if not selected for Travel
Both Rec. & Travel
Please complete information below: IMPORTANT: NEW & REQUIRED ↓ ↓
Mother or
MI Father __ __ / __ __
Last First
Birthday
Name: Name: (MM/DD):
Street Address: Apt #: City: St: OH
Zip Code: Phone #: ( ) DOB: Age: Sex:
E-mail Address: (Required)
Father’s Name:
Mother’s Name:
Alternate Phone #: ( )
Person in an emergency: Phone #: ( )
Doctor to Notify: Phone #: ( )
List any Medical Problems:
# of Seasons Last Team Date of Last Season Height Weight
Played
UNIFORM SIZE
FALL AND SPRING (circle one)
Youth Adult
Shirts XS S M L S M L XL
IMPORTANT LIABILITY WAIVER FORM
I, the parent/guardian of the registrant, a minor, agree that the registrant and I will abide by the rules of
the OYSAN, it’s affiliated organizations and sponsors. Recognizing the possibility of physical injury I, the parent/guardian for the above child release, discharge and/or
associated with soccer and in consideration for the OYSAN accepting the registrant for its soccer otherwise indemnify the organization/league/club for which I am
programs and activities (the Programs). I hereby release, discharge and/or otherwise indemnify the registering the child to play, Ohio Youth Soccer Association North, its
OYSAN, its affiliated organizations and sponsors, their employees and associated personnel, including affiliated sponsors, employees and associated personnel, including the
the registrant as a result of the registrant, participation in the Programs and/or being transported to or owner of fields and facilities utilized against any claim by or on behalf of
from the same, which transportation I hereby authorize. I further grant the OYSAN Parties the right to the registrant as a result of his or her participation.
use the player’s name, pictures and /or likeness in printed, broadcast and other material concerning the
Programs provided such use is related to the player’s status as a participant in the Programs.
Parent/Guardian Signature:__________________________________
Name: ____________________________________ DATE: ________________
[Parent/Legal Guardian (please print)] Date: __________________________
Signature: X_______________________________________________
CONSENT FOR MEDICAL TREATMENT (MINOR) PARENTAL SUPPORT OFFICIAL USE ONLY
As the parent or legal guardian of the above-named player, I hereby give consent for We ask for active participation of all parents
emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor in our program. Check area(s) in which you Registration Fees $
of Dentistry. This care may be given under whatever conditions are Necessary to would be willing to help.
preserve the life, limb or well-being of my dependent. Other $
Coach Committee
Signature/Parent or Guardian X Asst. Coach Concession TOTAL Received $
Team Parent Donations Still Owes $ _________
Address: Apt #: Field Preparation Clerical
Sponsorship Newsletter Cash Check #
City: OH Zip code:
Fund Raising Trustee Date Received: _________________________
Phone: Home ( ) Bus.: ( ) Registration Other*
SEASON: F F/S S
Publicity
*Other:
***ALL THREE SIGNATURE AREAS REQUIRED***
CLOVERLEAF SOCCER ASSOCIATION
SPRING 2012 REGISTRATION
WWW.CLOVERLEAFSOCCER.COM
Cloverleaf Soccer Association provides local children with the opportunity to learn and play soccer. We are
a community soccer league with players from surrounding school districts. Cloverleaf Soccer Association is a
family-oriented, volunteer organization which allows us, as parents, to have an active role in the decisions made
by the association and an opportunity to be a positive, supportive role model in our children’s lives. We need
the parent’s support in many aspects of the association to help run it successfully. Please check the parental
support section of this registration form if you can help in any way. It would be greatly appreciated.
AGES: Children must be 5 years old by March 1, 2012 to participate for the Spring 2012 season.
FEES: $55 per child for Spring only.
If your child plays Travel and would also like to play Rec., the fee is $30.00 per season.
** If you wish to be head coach for your child’s team and you are approved by the CSA
Board to coach, your fee will be refunded to you for your child.
SEASON: Approximately April thru early June 2012. U9 and above will practice at CSA
fields & play at CSA, Highland, Medina & Buckeye fields.
DEADLINE: All registrations MUST BE POSTMARKED NO LATER THAN February 10, 2012.
There is a late fee of $10.00 for registration forms postmarked after February 10,2012. We must hold
strong to the deadline so we can manage our jersey order and the scheduling of games. Once teams are full,
any registrations postmarked after February 10th 2012 will be notified and applied to a waiting list.
Additional registration forms can be downloaded from our website at www.cloverleafsoccer.com.
All registrations must be mailed (with check or money order-payable to CSA) to the following address:
CLOVERLEAF SOCCER ASSOCIATION
PO BOX 231
WESTFIELD CENTER, OHIO 44251-0231
ABSOLUTELY NO REFUNDS
CONTACTS: Anita Wilson 330-241-1153 anitawils16@gmail.com
Lisa Miller 330-242-1335 bldcmiller@aol.com
CLOVERLEAFSOCCER.COM---CLOVERLEAFSOCCER.COM---CLOVERLEAFSOCCER.COM
