LAST NAME:_______________________ FIRST NAME:_____________________
o Male o FemaleBirthday:______________________
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.
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.
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 andhazards incidental to such participation, and I do hereby agree to hold harmless the staff of the All Star Sports Arena from any and all claimsarising out of any injury to my child. Furthermore, this verifies that the player is up to date with his/her immunizations and is able toparticipate 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:________________________________________________________________________________
Please indicate if you would be able to coach your child’s team: YESNO
(Note: coaches’ main responsibilities will be to manage the team and oversee games. Qualified trainers will be provided for skills training during practices.)
Kendall Spencer/All Star Sports Arena Soccer / 1906 Cambridge St / Springdale, AR 72764