Presented in cooperation with the Detroit Recreation Department: 2015 Children’s Spring Soccer & Flag Football League April 18 - May 23 Beginners Welcome! All games will be played Saturdays at Balduck Memorial Park: Soccer: 4-5 yrs. 6-7 yrs. Flag Football: 8-10 yrs. 11-14 yrs. 7 - 9 yrs. Please use child’s age as of April 18, 2015 10 - 13 yrs. Please use child’s age as of April 18, 2015 The league fee is $40 until April 10; $50 after April 10 Please Note: No refunds after April 10, 2015 ESC provides Soccer uniform (jersey & socks) &/or Flag Football jersey For more info call: (313) 402-4575 or e-mail questions to [email protected] 2. Mail or Bring Registration & Payment to: 1. Register & Pay online at eaglesportsclub.com! All new online registration now available! Eagle Sports Club (Grace Comm. Church) ways 2 great er: to regist 21001 Moross Rd. - Detroit, MI 48236 (Moross Rd. & I-94; open daily 10 AM to 4 PM) Payment required with registration form; check or money order only when mailed Pay with Debit or Credit Cards! Girl _______ Select One Program: Soccer Age Divisions: 4-5 6-7 8-10 11-14 Boy _______ Flag Football Age Divisions: 7-9 New Eagle Sports Club Player Child’s Name: 10-13 Returning Eagle Sports Club Player 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. ABSOLUTELY no team assignments changes after Friday, April 10, 2015 Address: _________________________________________________________________ City: Primary Phone: State: Birth Date: / / Zip: Secondary Phone: School Attended: Email Address(es): _____________________________________________________________ Parent/Guardian’s Name: For ESC Use Only: Amount: __________ PM Type: __________ Date: ____________ Initials: ____________ (PLEASE PRINT) I would like to coach: ____________ I would like to Volunteer:_________ Additional Info & Waiver on back must be signed by parent or legal guardian www.eaglesportsclub.com EAGLE Children’s Charities is a 501(c) faith based children’s charity providing sports (EAGLE Sports Club), tutoring & camp programs for boys & girls ages 4 to 14. All games played at beautifully restored Balduck Park. Every child is coached with love, care, discipline, patience and most of all joy. EAGLE Children’s Charities, founded in 1998, serves Detroit’s eastside community children. Eagle Sports Club Participation Waiver - Please Read & Sign By signing below the parent(s) or guardian of _____________________________ (insert child’s name) agree to the following: 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. I / WE HAVE READ THE ABOVE WAIVERS FOR PHOTOGRAPHY CONSENT, RELEASE OF LIABILITY, AND CONSENT FOR MEDICAL TREATMENT AND UNDERSTAND THEM AND, BY SIGNING BELOW, AGREE TO THEM. ______________________________ _________________________________ Signature of parent or legal guardian Signature of parent or legal guardian Date: _____________________________ Date: ___________________________ Please Note: Except for 4-5 yr. olds - All ESC Spring Soccer & Flag Football teams will practice once a week in the early evening Monday through Friday. Coaches will inform you of practice night. 4-5 yr. old soccer teams typically do not hold practices. All games are Saturdays at Balduck Park starting Saturday, April 18 to Saturday, May 23. Practices are very important , missing an occasional practice will not impact 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 Soccer players must supply & wear shin guards; FF players must supply & wear mouth guards. There is a mandatory PARENTS’ MEETING on Monday, April 13 @ 7 PM at Grace Community Church. Please call 313-402-4575 for further information. Please Note: No Refunds after April 10, 2015
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