Litchfield Youth Soccer League Recreation
R E G I S T R A T I O N

Registration deadline for the spring season is: April 05, 2014

Recreation player fees: $45.00 per player, Cubs player fees: $30.00 per player,
Maximum player fees: $115.00 per family.
An additional late fee of $10.00 per player will be added to late registrations.
Cougar Cubs is for players that are a year too young for our recreation league. It is 6 sessions (instead of 8) that meet once a week to teach basic soccer skills. The goal of the sessions is to help players become excited about soccer and have fun!!
* Required
PARENT / GUARDIAN INFORMATION:
* First Name:

* Last Name:

* Phone:

E-mail:
First Name:

Last Name:

Phone:

E-mail:
* Street:
* City/Town: * State: * Zip:
* Emergency Contact: * Phone:
* Physician Contact: * Phone:
PLAYER 1 INFORMATION:
* First Name: * Last Name: MI:
* Gender: Female Male     * Date Of Birth:
Registration Age (age as of September 30, 2013): *
*Pursuant to the State of New Hampshire Soccer Association all players must be a minimum of age 3 by September 30, 2013. Due to safety reasons there are no exceptions.
Leagues:    Cubs (Age: 3)    Instructional (Ages: 4-5)    4v4 (Ages: 6-7)    6v6 (Ages: 8-10)    Senior (Ages: 11+)
Player's league based on registration age:
Comments/Requests (for example, weeknights that a 4v4 or 6v6 Player cannot make practice):
WE NEED YOUR HELP!! No experience necessary - just a willingness to help.
Without parent/coach volunteers, LYSL may be unable to have as many teams as needed. Yes!!! I can volunteer:
Coach Asst. Coach Team Parent Field Improvements
LYSL RELEASE:
I, the parent/guardian of the player(s), minor(s), agree that the registrant(s) and I will abide by the rules and regulations of the LYSL. Recognizing the possibility of physical injury associated with soccer participation and in consideration for the LYSL accepting the registrant(s) for its soccer program and activities ("the program"), I hereby release, discharge and/or otherwise indemnify the LYSL including its officers, referees, coaches, assistants, and other volunteer personnel as well as the owners of the fields, facilities used by the program, against any claim by or on behalf of the registrant(s) as result of the registrant(s)'s participation in the program and/or being transported to or from the same, which transportation I hereby authorize:
I agree *
CONSENT FOR MEDICAL TREATMENT (MINOR):
As parent of Legal Guardian of the above named player(s), I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatsoever conditions as may be necessary to preserve life, limb, or well being of my player(s).
I agree *
REGISTER:
Season fee: $
+ Late fee: $
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Registration fee: $