Registration Form

First Name

Last Name

Street Address

City

Zip Code

Birth Date Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018

Parent Guardian

Contact Phone

Contact Email

Which elementary schools do you live near? Choose a school AJ Katzemaier Elementary Greenbay Elementary Howard A. Yeager Elementary Marjorie P. Hart Elementary North Elementary South Elementary

What position(s) do you normally play? (check all that apply) Forward Defense Midfield GoalKeeper

Already have an uniform

Jersey Size Youth Small Youth Medium Youth Large Small

Short Size Youth Small Youth Medium Youth Large Small Medium Large Extra Large

Permission to Play I, the parent or guardian of the minor registrant, agree that the registrant and I will abide by all the rules of the Northside Youth Soccer League (NYSL). In recognizing the possibility of physical injury associated with soccer and in consideration for the “League” accepting the registrant for its soccer programs and activities, I hereby release, discharge, and/or otherwise indemnify NYSL, their employees and associated personnel and volunteers, including the facilities used for practices and games, against any claim by or on behalf of the registrant as a result of the registrant’s participation in the program and/or being transported to or from NYSL sponsored activities, which transportation. By signing below, I hereby agree and authorize the above. In addition, by signing below, I also acknowledge that I have read the cancellation policy and agree to its terms.

Parent/Guardian signature

Date of submit Day 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018