St. Cecilia Sports Program         2010 Fall Soccer Registration Form

·   U-6 soccer is open for players born between AUG 1, 2004 – JUL 31, 2006        -Requests for exceptions will be considered at the discretion of the St. Cecilia Sports Committee
·   Player Development Session will be held on SUN AUG  29 from 1:30-2:30 in an effort to provide basic skills training through various stations and provide instruction to volunteer parent-coaches;                   event confirmation will be sent to registered players approximately two weeks prior·   First game is expected to be SUN SEPT 12 with the season scheduled to end on OCT 24
·   This outdoor soccer league is an instructional league and utilizes 3 vs 3 ·   Games are played on SUN afternoons @ St. Cecilia (2:00 and 3:00); Practices are offered ½ hr prior to each game
                      Registrations can be mailed-in postmarked by AUG 14th      orQUESTIONS?  --     Contact Darrin McCaffrey at 363-1617 or via email at DMcCaffrey@magniindustries.com           
PLAYER INFORMATION
 Last Name:                             First Name:                      BOY / GIRL                                 Birth Date:        /        /                                                                                                                 (circle one)                               
 Street Address:                                         City:                                Zip:                              Phone:          
Prior Coach or Team Color                           Shirt Size(circle one):   Youth Xtra Small      Youth Small      Youth  Medium                                                                        Every attempt will be made to honor shirt sizes with on-time registrations; else will likely receive Youth Sm.

                                                                    Player School:                

Preferences/Notes/Allergies/Medical Conditions:
Please note: St. Cecilia Sports Committee (SCSM) will attempt to honor coach and teammate requests as practical.  However, the U-6 Soccer Coordinator will make every attempt to create balanced teams in the best interest of all players, primarily based on player evaluations conducted during the player development sessions.   Should you feel your child may be ready to move up a division, we request you speak with your previous coach and/or a member of the SCSM.  SCSM, along with input from the coaches and parent will consider requests to move players up a division based on the best interest of the child and roster availability.                                       PARENT/GUARDIAN CONTACT INFORMATION
 Name:                                   Email address:                                                   Phone:                                                                                                          
 Name:                                     Email address:                                                   Phone:          
 VOLUNTEER INFORMATION  (Please circle activity in which you are interested)
           Coach                             Asst. Coach                         Field Lining                                            Administration
Please Circle the Name of the Parent/Guardian Listed Above Offering to Volunteer         Virtus Certified?:           Y / N
 INDEMNIFICATION & LIABILITY WAIVER
I, the parent/guardian of the above named Player, a minor, agree that I and the player will abide by the Rules and regulations of the soccer league, the affiliated organizations, and it’s sponsors. In consideration of the player’s participation in the soccer programs and activities of the soccer league parties I, for myself and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the soccer league parties, the owners and operators, employees, agents and representatives from against all claims, liabilities, damages or causes of action arising out of or in connection with the players participation in the programs. I also understand that this is a recreational soccer league and unsportsmanlike conduct will not be tolerated from the players or parents. Coaches will have the right to dismiss a player from the team for offensive behavior demonstrated by that player, their parent, or Guardian, while at practice or a game.  In signing the below, I testify that I am a Legal Guardian of the above-named Player.LEGAL GUARDIAN SIGNATURE
 NAME:                                     Signature:                                Date:
 FEES (please check all that are applicable)

U-6 $30 per Player              or   Family Rate ALREADY Paid $150 (includes older age brackets)

Late Fee - $10 per player (if post-marked after AUG 14th (please contact me prior)

On-site registration ($40 per player) will be accepted on SUN MAR 21h (weather permitting) 1:00-1:30 at St. Cecilia Soccer FieldsHardship circumstances, please contact Darrin McCaffrey at 859.363.1617
Please mail completed form along with check - made payable to “St. Cecilia Sports Program”- to:  
Darrin McCaffrey    4972 Open Meadow Drive    Independence  KY   41051
 

 

                St. Cecilia Sports Program

         2010 Fall Soccer Registration Form

Soccer Registration will be June 22nd . 2010  6:30-8:00PM. Please mail form postmarked no later than July 23rd. Mail to: Darrin McCaffrey 4972 Open Meadow Dr., Independence,KY 41051.
           
 Last Name:                                       First Name:                                  Phone:
 Street Address:                                        City:                                  St:            Zip:      
Birth Date:      /     /           Sex:           Prior Coach:                          email:

Player School:                                                      Last 5 Digits SSN#:

          Yes, I am interested in helping in the following areas: (circle)            
Coach                Asst. Coach                  Referee                        Field Lining       Administration      
Email:                                                                    Phone:

         

Yes, I am interested in helping in the following areas: (circle)            Coach                Asst. Coach                  Referee                        Field Lining            Administration       Email:                                                                    Phone:
  Please note: All new players will be randomly assigned to a team, per league rules. It is a privilege, not a right to move up   a division.

 Circle One                    U8                               U10                            U12                   U14                                U16                  
                                           August 1,2002                          August 1,2000                      August 1,1998            August 1,1996                        August 1,1994                  
                                            July 30, 2004                           July 31,2002                          July 31,2000              July 31,1998                            July 31,1996

U8-U16- $75 per player
 
-Check if new player: $30 new uniform PREPAID (if needed).
Family rate-$150 (includes U6)Late fee-$10 per player

(After: Tuesday th).

Hardship cases:  (Contact:Darrin McCaffrey (895)363-1617.

 

 
I, The parent/guardian of the above named player, a minor, agree that I and the player will abide by the

Rules and regulations of the soccer league, the affliated organizations, and it’s sponsors. In  consideration

of the player’s participation in the soccer programs and activities of the soccer league parties I, for myself

and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby

release and indemnify the soccer league parties, the owners and operators, employees, agents and representatives

from against all claims, liabilities, damages or causes of action arising out of or in connection with the players

participation in the programs. I also understand that this is a recreational soccer league and unsportsmanlike

conduct will not be tolerated from the players or parents. Coaches will have the right to dismiss a player from the

team for offensive behavior at practice or a game.

Make Checks Payable to:St. Cecilia Sports Program 
Mother’s Name:    
                                              
Father’s Name:   
           
                   
Sports Program Use Only----do not write below this line---Date:                       Time:                       Birth Certificate:                     Amount paid:                          Chk#:

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