Reading Soccer - Online Registration

READING SOCCER

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Online Registration

YOU MUST CLICK THE BUY NOW BUTTON FIRST TO PAY, UNLESS YOU ARE SIGNING UP A KICKERS OR SENIORS PLAYER. (IF YOU ARE SIGNING UP A KICKERS OR SENIORS PLAYER, THEN JUST FILL OUT THE FORM BELOW AND YOU WILL RECIEVE AN EMAIL TO MAKE PAYMENT. YOU WILL NOT BE CHARGED THE $10 LATE FEE). AFTER PAYMENT IS MADE YOU WILL THEN BE REDIRECTED BACK TO THIS PAGE TO COMPLETE THE REGISTRATIOIN FORM BELOW. PRICE DOES REFLECT THE $10 LATE FEE FOR INSTRCUTIONAL, PASSERS, WINGS AND STRIKERS.

Parents Email Address:
What city do you reside in?	Reading Lockland Amberly Village Arlington Heights Other
Parents Last Name:
Parents First Name:
Address:
Zip Code:
Home Phone Number:
Cell Phone Number:
Would you like to coach or assist?
Player's last name:
Player's first name:
Male or female (player):	Male Female
Player's birthdate:
Player's age as of 8/1/2010:
Emergency contact person with phone number (must be diffrent then parent's):
Doctor with phone number:
Did you play last season?
Last level played:	Instructional Passers Wings Strikers Kickers Minors Seniors New Player
Is your brother or sister playing?
Are their any allergies or disabilities that your coach should know about?
Jersey Size:	YXS YS YM YL AS AM AL AXL
Sock Size:	XS S M L
By placing your initials in this box you agree that as the parent or legal guardian of the above named player, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well being of my dependent.
By placing initials in this box you hereby agree the Soccer Association for Youth(SAY), its members, coaches or officers shall not be liable for any injury or loss which my child or children may sustain while participating in activities of any kind whether sponsored by or under the supervision of SAY and we agree to indemnify and to hold harmless SAY, its members, coaches, officers or designates of any kind from any claim whatsoever.

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