FALL 2011 YOUTH SOCCER INDIVIDUAL REGISTRATION

 (6 Saturday games & Monday 6PM Practices)

Start date: Practice Monday 9/12/11   First Game 9/17/11

Registration Due: 9/05/11

LAST NAME:_______________________ FIRST NAME:_____________________

o Male o Female              Birthday:______________________

Circle Program or League:

PRE-SOCCER (3-4 YR. OLDS) This program is designed to introduce soccer skills through fun activities.  Players are gradually introduced to soccer games.   Great program for beginners.

LEAGUES: (If born between these dates) U5: August 2006 - July 2007   U6: August 2005 - July 2006                                                             

 U8: August 2003- July 2005    U10: August 2001 - July 2003     U12: August 1999 - July 2001

§   U5 and U6 play 3v3 on half a field.   U8 & up plays 6v6 on the full field.

§   Note: older players may participate by forming a school team and playing in an Elementary School league.  We are not taking individual registrations for these players.

Address ______________________City/State/Zip______________________________________

Email Address____________________________________ Cell Phone: (_____)____________________

Parent/Guardian Name ____________________________Home Phone: (_____)____________________

Medical Insurance Co.: ______________________________Policy No. :__________________________

Parental release: This is to certify that my son/daughter has permission to participate in any and all soccer activities. I assume all risks and hazards incidental to such participation, and I do hereby agree to hold harmless the staff of the All Star Sports Arena from any and all claims arising out of any injury to my child. Furthermore, this verifies that the player is up to date with his/her immunizations and is able to participate in all soccer activities. In the event of injury my permission is granted for treatment as required at the nearest medical treatment facility.

Medical Problems:________________________________________________________________________________

Guardian's Signature:______________________________________________________________________ 

Please indicate if you would be able to coach your child’s team:  YES       NO

(Note: coaches’ main responsibilities will be to manage the team and oversee games.

Qualified trainers will be provided for skills training during practices.)

Pre-soccer:$60

U5-U10 Leagues: $75

TOTAL PAYMENT:______________________  DATE RECEIVED:______________________

(Make check payable to “All Star Sports Arena”)

IMPORTANT NOTE: Enrollment is limited. Full and final payment is due at the time of registration.

Kendall Spencer/All Star Sports Arena Soccer / 1906 Cambridge St / Springdale, AR 72764

For more information call: Kendall Spencer 713-0853 Kendall.soccer@yahoo.com

Visit Allstarsportsarena.com for any & all new information on leagues and practices!!!