Ketchikan Youth Soccer League 2015 INDOOR SOCCER Registration dates: November 1 – December 1, 2014 P.O. Box 5271, [email protected], 225-5975 Season begins week of January 4th Registration Fees: $85.00 Nov. 1-Dec. 1 $100 late registration after Dec. 1 IMPORTANT: **There is no guarantee of team placement! Once a division is filled, a wait list will be started. **KYSL does not ‘play up’ participants. DIVISIONS by grades: please check one ____ 2nd & 3rd grade ____4th & 5th grade Please use only one form per child! Name: _____________________________________ Birth Date m/d/y ______________________ Circle One: M Current Grade: F _______________ School: _____________________________________ If this is your first time playing soccer in Ketchikan, have you played indoor soccer before? ____6th-8th grade ____ 9th-12th grade Release of Liability: In consideration for permitting my child to participate as a player in the Ketchikan Youth Soccer League (KYSL), I hereby waive, release and discharge Ketchikan Youth Soccer League (KYSL), Alaska Youth Soccer Association (AYSA) its officers, board members, coaches, referees, players and successors from liability of any nature whatever arising from or growing out of the participation of my child in any of the activities of KYSL/AYSA. The undersigned parent/guardian of the above minor does hereby authorize the officers, coaches or agents of the KYSL to transport as required the above minor to and from authorized KYSLSPONSORED activities. If yes, years of experience: _________ Player’s email (if applicable): ___________________________________________ Father’s Name: ______________________________ Address ______________________________ City/State/Zip________________________________ Home Phone: Cell: ______________________________ ____________ Wk: _________________ KYSL strives to keep all teams equal and balanced. We will not be able to accommodate player, carpool or coach request. Father’s E-mail:______________________________ Coach? YES NO Assistant Coach? Referee? YES YES NO NO Mother’s Name: ______________________________ Address Extracurricular Activities (i.e. dance, swim, b-ball, etc.) only during soccer season ______________________________ City/State/Zip________________________________ Home Phone: Cell: ______________________________ ____________ Wk: _________________ Mother’s E-mail:_____________________________ Coach? YES NO Assistant Coach? Referee? YES YES NO NO Please list siblings playing in same division: _________________________ Office use: ________ Date ____________ Pymt. RULES ON JEWELRY AND ADORNMENT: