YOUTH 3v3 LEAGUE  SUMMER SOCCER 2011 

                                                                       All teams play 3v3 on half a field.

INDIVIDUAL REGISTRATION

 2-(30min.) Saturday games/bi-weekly/ 6 games total/ 3 Monday 6PM Practices

DEADLINE TO REGISTER: 6/3/11

Start date: Practice Monday 6PM: 6/13/11

First Game: 6/18/11

LAST NAME: _______________________ FIRST NAME: _____________________

 O Male o Female              Birthday: ______________________

Circle Program or League:

LEAGUES:  U6 (8/1/04 – 7/31/05)     U8 (8/1/02 – 7/31/04)     U10 (8/1/00-7/31/02)     U12 (8/01/98-7/31/00)  

                                              U14 (8/01/96-7/31/00)         

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.)             

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!!!

Soccer Program $60 (summer discounted rate)

(Make check payable to “All Star Sports Arena”) DOES NOT INCLUDE UNIFORMS /SHIN GUARDS ARE REQUIRED!

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