2015 Recreation Registration Form

Freeland Soccer Club Registration Fall 2015
www.freelandsoccer.org
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Dates: Tuesday, June 2nd and Wednesday, June 3rd from 6-7:30 pm
Place: The Freeland Soccer Fields (Freeland Middle School)
Age Group Eligibility as determined by Michigan State Youth Soccer Association Seasonal Year
Fall 2015 thru Spring 2016
check the box that applies
NEW! (U4 COED 8/1/11 - 7/31/12)
(U10 8/1/05 - 7/31/07)
(U6 8/1/09 - 7/31/11)
(U12 COED 8/1/03 - 7/31/05)
(U8 8/1/07 - 7/31/09)
**In an effort to promote fairness and good sportsmanship, we WILL NOT accept special requests.
This includes requests for coaches and teammates**
Players Name
Address
City
Zip Code
Phone Number
Age as of August 1, 2015:
Circle One:
Male
Birthdate
(mm/dd/yy)
Parents E-Mail
(Must be 3 years old)
Female
It is important for FSC to have a clear understanding of any special concerns when placing your child on a team. FSC highly encourages children to
participate at all ability levels, including some children with special needs. Under some circumstances, parents/guardians may be asked to assist at
practices and at games.
Coaches Needed!
You will be reimbursed 50% for registration if you are the Head Coach for your child’s team.
Head Coaches are vital to the operation of the Freeland Soccer Club.
No Coach = No Team! Please fill out this information to volunteer to Head Coach This child’s team. Please print clearly.
The majority of communication to coaches is through e-mail so please provide an e-mail that you read regularly.
Name
Head or Assistant
Address
Phone Number
E-Mail
Cost per Player
$60.00 per player;
$20.00 Freeland Soccer Club Jersey;
NSF Checks will be subject to a $20.00 fee.
$20.00 Late Fee (per family) for registrations received after Friday, June 26th, 2015 and will be on a wait list.
JERSEY ORDER FORM (jerseys can be used for multiple seasons) they run small
Youth Small
(5/6) _____
Adult Small
Youth Medium (8/10) _____
Adult Medium
Youth Large
(12/14) _____
Adult Large
(Socks and shin guards are MANDATORY for practice and games.)
_____
_____
_____
Refund Information
Refund policy- Due to the work involved in putting teams together, the following refund policy will be in place. All refund
checks will be sent within 30 days of refund approval.
* 50% Refund - Request made before season begins
* 100% Refund - Due to injury*Moving out of area*
Player makes travel/high school team* No coach volunteers for the team*
*Not enough players in an age group to form a team*Unable to place late registrants on a team
th
Summer Soccer Camp
11 Annual British Soccer Camp - August 3rd thru August 7th, 2015, Held at the Freeland Soccer Fields on Webster Road
If you would like more information regarding the camp please contact www.challengersports.com or Elizabeth Burnett at
573-4069 or [email protected]. Register on-line at www.challengersports.com by June 17th and receive a free
authentic British Soccer replica jersey!
Freeland Travel Soccer Try-outs will be June 13th and 14th
Look for team information and times on www.freelandsoccer.org after June 1st if you would like more information on the
Freeland Travel program, contact Melanie Steffen at [email protected] or 989-714-5176. Distribution of this
information by the Freeland Community School District does not constitute an endorsement of this program.
Hold Harmless and Indemnification Agreement
I give my approval for _______________________to participate in any and all FSC activities during the season covered by
this registration. I assume all risks and hazards incidental to such participation, hereby waive, release, absolve and agree
to hold harmless the Freeland Soccer Club, the Board of Directors, the organizers, sponsors, league officials, coaches,
referees, Freeland Schools, volunteers and participants from any claim arising out of any injury except to the extent
covered by accidental or liability insurance. The undersigned parent or legal guardian attests the aforementioned player
is in good health; physically and mentally capable of participating in the current soccer program, and that the
information given here is correct. It is further agreed that we will abide by the rules and regulations of the Freeland
Soccer Club, the Michigan State Youth Soccer Association, the United States Youth Soccer Association, and the United
States Soccer Federation. Please notify your child’s coach of any health conditions, which might limit the registrant’s
soccer activities. I understand that my child will play on the team they are assigned.
Signature
Date
Parent(s) or Legal Guardian(s) Names (Print)
Registration fees will cover membership and registration with the USSF, MSYSA, and Supplemental Medical and Liability
Insurance to cover you, the games, practices, referee fees and all other fees.
Mail-in Registration due by Friday, June 26, 2015:
Send completed registration form and check made out to:
Freeland Soccer Club, P.O. Box 45, Freeland, MI 48623
For more information visit our website at www.freelandsoccer.org
For information regarding registration: Rachel Engelhardt 948-8042 or [email protected]
For information regarding teams, coaching and games schedule: Shannon Lloyd 280-3064 or [email protected]