LebCo United 2015 Tryout Registration Sunday, April 19, 2015 Tryout Location: Dates/Time: Ages: Rain date/Location: Cedar Crest High School Stadium Field Sunday, April 19th (IMPORTANT: Plan to arrive 30 mins PRIOR to your start time and report to the Registration Area at the entrance of the stadium) U9 & U10 12:30-2:30pm U11 & U12 2:00-4:00pm U13 & U14 3:30-5:30pm U15 - U19 5:00-7:00pm Boys / Girls 8 – 18 (prior to 8/1/15) *U10 would be a player under 10 years as of 8/1/15 See www.lebcounited.com website for posting LebCo United Philosophy & Successes:  Top-level competitive program creating better opportunities for youth in our county to play soccer at the highest level commensurate with their individual ability and potential  Fully licensed coaches with minimal training fees to make the program both valuable and economical   EPYSA Challenge State Cup winner, Region 1 Finals of the Presidents Cup, league championships Grants and Scholarships available for eligible players Player’s Information Circle Name:___________________________________________ Date of Birth (M/D/YY): _____________ M F Address: _______________________________________________________________________ City:______________________________________ State: ___________ Zip:________________ Mother’s Name_______________________ Phone: (_____)__________Cell: (_____)__________ Father’s Name________________________ Phone: (_____)__________Cell: (_____)__________ Email Address (IMPORTANT):_____________________________________________________ ______ Please check this box if also trying out for goal keeping. There will be a separate testing area within your scheduled time. LebCo Travel Soccer Program: Annual cost will be significantly less than other travel programs – current annual costs are approx. $400. These costs are to cover indoor league play, gym rental / field costs, spring and fall registration, ref fees, tournaments and other misc costs. The coaching staff is formally trained / licensed with years experience instructing youth soccer. Uniforms are purchased by the players and range from $60-90 based on number of jerseys, socks, etc. Payment Information: $10 per player to cover facility costs and equipment if paid by APRIL 1, 2015 with a check made payable to “LebCo United.” After that date, fee is $12. Register form is also available online at www.lebcounited.org. LebCo United 140 Tiverton Court Lebanon, PA 17042 ATTN: LebCo United Tryouts Release Statement NOTE: The Statement should be signed by parent/guardian for minor player; an adult player for himself; coach for himself; and administrator for himself. I, the parent/guardian of the registrant, a minor, or adult registrant of legal age, agree that I and the registrant will abide by the rules of the EPYSA, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the EPYSA accepting the registrant for its soccer programs and activities (the "Programs"), I hereby release, discharge and/or otherwise indemnify the EPYSA, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized for the Programs, against any claim by or on behalf of the registrant as a result of the registrant's participation in the Programs, and/or being transported to or from the same, which transportation I hereby authorize. Parent / Guardian Signature___________________________________ Date:________________