LANCHESTER TRAVEL REGISTRATION FORM
Fall ’15 – Spring ‘16
Form must be completed. Tryouts are FREE
Octorara Soccer Club - PO Box 73 Atglen, PA 19310
www.octorarasoccerclub.com & [email protected]
Player Information
Name: (First) ________________________________ (Last) ___________________________
Address: ____________________________________________________ Telephone:____________________
City:_________________________ State:_____ Zip:_________ Emergency Cell Phone__________________
Male / Female
Birth Date: __/__/__
Circle One
MM
Years of Intramural _______ Years of Travel _______
DD YY
School: _________________________________________
Email (1): _________________________________ Email (2): _______________________________________
OSC - DOES NOT DISCRIMINATE BASED ON RACE, RELIGION OR GENDER.
Details:
• There is NO fee to try out for a travel team.
• Wear a white or very light colored t-shirt
• Each player wishing to play on a team MUST attend at least one tryout.
• Players will be notified via email, letter or phone between Mon. June 8th - Fri. June 12th
• If your child is selected for a team, the approximate registration/league fee is $200 for the year (Fall &
Spring seasons). Your team may choose to play 1-2 tournaments and Indoor league/training. This is decided
on by each team & the approx. additional cost is $100 for all three. Uniforms are approx. $65 p/player.
• Your acceptance to an offer to play for a travel means you will play both Fall & Seasons.
• Uniform fittings, registration payment and collection of needed paperwork will occur on Tues June 16th,
Wed June 17th & Thurs, June 18th
• If weather is an issue during tryouts we will reschedule.
• LanChester participates in either Lanco or PAGS Fall & Spring leagues
When – Dates & times below
Where – Register onsite at Octorara Primary Learning Center 87 Highland Rd Atlgen, PA 19310. Soccer field to the right of the
building as you look at it.
Teams – U10 – U15 girls and boys
Boys Tryout Schedule
Tuesday
Wednesday
Thursday
Sunday
May 12th
May 13th
May 14th
May 17th
Girls Tryout Schedule
6–7:30pm
6-7:30pm
6-7:30pm
6-7:30pm
Tuesday
Wednesday
Thursday
Sunday
May 12th
May 13th
May 14th
May 17th
6–7:30pm
6-7:30pm
6-7:30pm
6-7:30pm
LANCHESTER TRAVEL REGISTRATION FORM
Fall ’14 – Spring ‘15
Form must be completed. Tryouts are FREE
RELEASE STATEMENT: I, the parent/guardian of the registrant, a minor, an adult registrant of legal age,
agree that I and the registrant will abide by the rules of the EPYSA, OCTORARA SOCCER CLUB (OSC), its
affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and
in consideration for EPYSA and OSC accepting the registrant for its soccer programs and activities, I hereby
release, discharge and/or otherwise indemnify EPYSA, OSC, its affiliated organizations and sponsors, their
employees and associated personnel including the owners of the 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 in case of emergency, which transportation I here authorize. I also authorize the full
use of my child’s photo and or likeness by OSC on their website, flyers, or other such advertisements or photo
opportunity events sponsored by OSC.
Parent/Guardians Name _____________________ Parent/Guardians Name ___________________
Parent/Guardian Signature ___________________________________________
Date: _________