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Spring Soccer _ Flag Football League


									                                                     2011 Children’s                                               In Partnership with:

                                            Spring Soccer &
                                          Flag Football League
                                                  April 9 - May 14
                                                       Beginners Welcome!
                   All games will be played Saturdays at Balduck Memorial Park;
                      Located at the corner of Canyon St. & Chandler Park Dr.

                        Soccer:                                                          Flag Football:
  4-5 yrs 6-7 yrs. 8-10 yrs. 11-14 yrs.                                             7 - 9 yrs.              11 - 13 yrs.
          Please use child’s age as of April 9, 2011                            Please use child’s age as of April 9, 2011

                The league fee is $ 35 until April 1; $ 50 after April 1
              ESC provides Soccer uniform (jersey & socks) or Flag Football jersey;
                      Soccer players must supply and wear shin guards;
                   Flag Football players must supply & wear mouth guards.
                 For more info call: (313) 402-4575 or e-mail questions to

           Mail registration form with $ 35 payment                                      Eagle Sports Club
            (check or money order) by April 1 to:                                        21001 Moross Rd.
                 (payment required with registration form)                               Detroit, MI 48236

                                                          Select One Program:
  Girl _______               Soccer Age Divisions:              4-5         6-7          8-10            11-14
  Boy _______
                             Flag Football Age Divisions:                 7-9                10-13

                             New Eagle Sports Club Player                  Returning Eagle Sports Club Player

Child’s Name:                                                             Grade:                        Age:

Coach/Team/Teammate Request*:
        * ESC makes every effort to honor all requests but reserves the right to place your child on any team.

Address: _________________________________________________________________               Birth Date:           /       /

City:                                                  State:                              Zip:     ________

Primary Phone:                                                        Secondary Phone:

School Attended:

Email Address(es): _____________________________________________________________

Parent/Guardian’s Name:                                                                         I would like to coach: ____________
    For ESC Use Only:                         (PLEASE PRINT)
Amount: __________                                                                              I would like to Volunteer:_________
PM Type: __________
                                 Waiver on back must be signed by parent or legal guardian.
Date: ____________
Initials: ____________
                                               Eagle Sports Club
 By signing below the parent(s) or guardian of _____________________________ (insert child’s name) agree to the

                                            Photography Consent Agreement

 I / We hereby grant to Eagle Sports Club, and their staff, volunteers, agents, successors, licensees and assignees, the
irrevocable right and license to use my photograph or the photograph of my child: to edit or crop photograph, and use or
authorize the use of such photographs or any portion thereof in any manner or media at any time in perpetuity and to use
my name, likeness, biographical or other information concerning me in connection therewith, including promotion in all
media. I agree to hold Eagle Sports Club harmless against any liability, loss or damage resulting from the use of my
photograph, and hereby release and discharge this organization from any and all claims whatsoever in connection with
such use of photographs.

                                   Release of Liability and Acknowledgment of Risk

 I / We recognize that serious injury sometimes occurs in connection with athletic activities, and hereby exonerate Eagle
Sports Club, it’s employees, coaches, volunteers or parents from any liabilities in connection therewith. Eagle Sports
Club does not provide individual accident insurance. We strongly encourage participants to seek a doctor’s approval
before participating in an athletic activity. Participants and spectators are responsible for adequately protecting
themselves against cost of injury or property damage.

                                         Consent for Treatment of Minor Child

 In my absence, I / We authorize medical, surgical and dental treatment, both emergency and non-emergency, considered
necessary and proper for the diagnosis and treatment of my (our) child listed above. I / We further authorize the
manager, coach, assistant manager, and assistant coaches to cause my / our child to be transported to the nearest medical
facility for treatment of any injury or illness. I / We further realize and hold harmless Eagle Sport Club, its employees,
coaches, volunteers or parents from any liability as the result, direct or otherwise, of this transportation or medical care.
I hereby assume responsibility for any such treatment.

I also certify that my child is in good health and has no restrictions from competing in organized recreational activities.


________________________________________                  ________________________________
Signature of parent or legal guardian                     Signature of parent or legal guardian

Please Note: ESC Spring Soccer & Flag Football teams practice day & time will be
determined by the team coach. All teams will practice once a week in the early
evening Monday through Friday. 4-5 Soccer teams typically do not hold practices.
All games are on Saturdays at Balduck Park starting Saturday, April 9 and concluding
Saturday, May 14.
Practices are very important but missing an occasional practice will not effect your
child’s game play.
Soccer Game Times will be: 4 - 5 yr. olds @ 10 AM; 6 - 7 yr. olds @ 11:30 AM;
8 - 10 yr. olds @ 1 PM; 11 - 14 yr. olds @ 2:30 PM
Flag Football Game Times will be: 7 - 9 yr. olds @ 10 AM; 10 - 13 yr. olds @ 12 PM
There is a mandatory PARENTS’ MEETING on Tuesday, April 5 @ 7 PM at Grace
Community Church. Please call 313-402-4575 for further information.

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