2017tcysa.info/yahoo_site_admin/assets/docs/CoachPacket_5... · 2017. 10. 13. · 5 Tioga County...

2017 Your Coach’s Packet Should Contain:

List of TCYSA Officers, Player Agents, Referees and contact numbers.

Team Contact Information

Six town maps

Lightening Safety information

Injury Report Form – local only (for TCYSA) and links to soccer insurance info/forms

TCYSA rulebook - for teams playing traditional games. 4v4 rules are separate and included in the pages of this coach packet.

If something is missing or you need further information, email or call your area Player Agent.

You will notice gaps in the list. We are hurting for people willing to help! Many of us are doing multiple jobs. If you can volunteer for some organizing responsibility, we meet the third Monday of the month in April, May, June, July, Sept. and October, in Candor at the Elementary School library, 7 pm. If you would like to be a part of making TCYSA a better club, please volunteer to help organize!

THANK YOU FOR COACHING AND

MAKING TCYSA POSSIBLE FOR THE

KIDS!

Welcome to another fall TCYSA soccer season!

Just a couple rule changes this year.

Concussions:

Any player at any time who sustains a head injury must leave the practice field or game. If there are any signs of concussion, they may not re-enter play or practice. The child must be seen by a doctor and may not return to practice or games without a doctor’s note clearing him or her to play. This is national policy, not just TCYSA.

U10 playing rules – There was a change in rules last year (2016) brought about by concussion policy; there is a slight tweak to the rule this year:

U10 rules – No heading - this is a national USSF standard now. Goalkeeper may NOT punt, but a roll, low throw in or ground kick distribution is

OK Defenders MUST retreat to halfway line for a goal kick or GK distribution,

(with this exception: at goal keeper’s discretion, s/he may choose to make a quick release or kick, without waiting for the other team to assemble at the halfway line.)

NEW: The other team may attack the ball (come off the halfway line, if they got that far).

Defenders CAN cross the halfway line when Goal Keeper releases ball (roll, low throw

in or ground kick distribution)

This is a very special year. We are honoring Sally Marx for over 30 years of dedicated service to TCYSA! Joining TCYSA in the late 1980’s, she helped start

the Spencer program and became the first player agent for the Township. At the same time she started her tenure as a TCYSA board member. She has been the

president of TCYSA for the last 20 years finally deciding to make 2016 the last year and retiring at the end of the season. As the new president I can say

these are some big shoes to fill. Our communities have been blessed to have had a person like Sally who has been so invested in our kids through youth sports. Thank you Sally, you are so appreciated and will be missed!

The transition has caused a little bit of a bumpy start, there has been a learning curve for me. The league will continue to experience change next year. Player

agents from Apalachin, Candor and Newark Valley will be retiring at the end of 2018 season. We will be looking to find replacements for player agents and

board members. If anyone is interested in getting involved, we will have the next TCYSA board meeting October 16, 2017 at 7 pm. Check website or

Facebook for location.

Thanks and have a great remainder of the season! Rick Kuklish

TCYSA President

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Attention! Important items to remember

Give equal playing time to all players, regardless of skill or practice attendance. Promote good sportsmanship. Keep a positive attitude, positive tone of voice, and use encouraging words.

Respect the referee’s decisions without comment - and have players and parents do so as well.

Come and play with however many players you have. It is a commitment and responsibility to show up! If one team is short players, the other team must “play down,” or loan players to the short-handed team to even the numbers.

If a game must be rescheduled due to weather, flooding, etc., contact your area Player Agent ASAP. The referee needs to be contacted, too, through the Pl. Agent.

Contact the opposing team’s coach early in the week to confirm game time, location, shirt colors. If the opposing team’s color is similar to yours, have one team wear pinnies (bring them along just in case!) Be sure you have a shirt or pinney color for your goal keeper which is DIFFERENT from the colors of either team.

NO JEWELRY! Players cannot wear earrings, rings, bracelets, necklaces, etc. SUBSTITUTIONS: on any stoppage with the permission of the referee.

If thunder is heard or lightening seen, immediately stop practice or the game and seek safe shelter in vehicles until the danger is well past.

TCYSA IS NON-COMPETITIVE! No scores or standings are kept. Keep it FUN, POSITIVE, and EQUAL for all! We discourage trophies, too, since this is a non-competitive league.

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Tioga County Youth Soccer Association Officers - 2017

President Rick Kuklish (607) 354-6518 [email protected]

V.P. of Coaches Vacant - please volunteer!

Treasurer Joanna Sailus (607) 221-4058 [email protected]

Secretary Teresa Pirger (607) 765-5209 [email protected]

Equipment Chair Ron Maas (607) 744-7005 [email protected]

Uniform Chair Kathy Kuklish (607) 354-6519 [email protected]

Scheduling Chair Chris Hohman (607) 625-4660 [email protected]

PLAYER AGENTSTown Name Phone EmailApalachin Wes Wilkert (607) 727-6373 [email protected] Jennifer Potter (607) 592-5554 [email protected]

Carrie Whitmore (607) 857-5679 [email protected] Valley Joanna Sailus (607) 221-4058 [email protected]

Teresa Pirger (607) 765-5209 [email protected] Jennifer Kotski (607) 972-3237 [email protected]/Van Etten Jason Vanderpoel (607) 481-4748 [email protected]/Nichols Kim Luther (607) 220-9585 [email protected]

New York State West Youth Soccer Association11397 LPGA Drive Corning, NY 14830http://www.nyswysa.org (607) 962-9923

Binghamton Commissioner Kevin Arnold 607.756.6528 [email protected] Referee Administrator Bill Campbell 607.273.7414 [email protected] Administrator Scott Craig 607.962.9923 [email protected]

REFEREE ASSIGNORSWilliam Campbell 607-273-7414 [email protected] Candor, SPVKen Haller [email protected] Apalachin, T/N, Owego, NVJames Pitcher 607-743-1984 [email protected] Back up for Ken Haller

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ApalachinAge Color Sponsor Contact /Coach Phone EmailKinder Yellow PEAK PerformanceKinder Light Blue Nick's GarageKinder Green Next to Kin Ryan Hallenbeck 760-2043 [email protected]/7 Lime Green Tioga Fitness Center Heather Chrysler 972-1178 [email protected]/7 Royal Blue Nick's Garage John Purtel 625-3170 [email protected]/7 Maroon Lions Club Mary Reynolds 321-5367 [email protected]/9 Orange Hammond's Insurance Elena Beyer 687-1316 [email protected]/11 Yellow Bud's Place Eric Jones 205-7580 [email protected]/11 Dark Green Donoli's Matt Walsh 759-7884 [email protected]/11 Red Big Dipper Ron Maas 744-7005 [email protected]

CandorAge Color Sponsor Contact /Coach Phone Email6/7 Pink Candor Market Angela Heidl 607.280.2074 [email protected]/7 Light Steel Kirk's Excavating Rick Young 607.438.0380 [email protected]/9 Light Blue Tioga State Bank Scott Morse 607.760.3153 [email protected]/9 Red Stormpeak Crossfit John and Karen Jantz 607.227.6813 or

[email protected]

10/11 Light Blue Fay's Fitness Falcons Kevin Coppage 607.727.1395 [email protected]/11 Orange Iron Kettle Farm Jason Banks 607.659.7875 or

[email protected]

Newark ValleyAge Color Sponsor Contact /Coach Phone EmailKinder Lime Green Diana's Angels Sam Whitney 607-351-0058 [email protected] Lime Green Cooley's Kickers Sam Whitney 607-351-0058 [email protected] Lime Green Hollenbeck's Sam Whitney 607-351-0058 [email protected]/7 Black Frost-Klossner-Swan Cayli Young 607-743-6185 [email protected]/7 Red NV United Sports Affiliates Jason Brodfeuhrer 607-727-0455 [email protected]/9 Royal Blue Visions Federal Credit Union Alissa Franco 732-773-3199 [email protected]/9 Maroon McElwain Engineering Rich Perkins 607-349-2856

[email protected]

10/11 Teal Green Westcode Maddy Sherwood 607-422-1490 [email protected]

TCYSA 2017 - Team ContactsIf no contact is listed, please contact the player agent for that area to make contact.

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OwegoAge Color Sponsor Contact /Coach Phone EmailKinder Purple Purple Ninjas Jennifer Kotski 607-972-3038 [email protected] Black Baker's Garage Doors Philip Baker 607-765-2114 [email protected] Red The Owego Pharmacy Jason Luke 607-240-9114 [email protected] Yellow Mario's Pizza Melissa Brown 518-391-2683 [email protected] Light Blue New Vision Industries Jason Luke 607-240-9114 [email protected] Green Ice Cream Works! Rick Kuklish 607-354-6518 [email protected] Orange Owego Carstar Priscilla Prentiss 607-759-2897 [email protected] Royal Blue Blue Box Brawlers Jennifer Kotski 607-972-3038 [email protected] Black Owego Agway Joshua Signs 304-710-0343 [email protected] Lime Green Lawler's Grocery Store Nicole Kobziewicz 607-725-0580 [email protected] Teal Green Teal Tornados Jessica Barnes 607-687-5705 [email protected] Royal Blue Doc's Homebrew Supplies Craig Wademan 607-687-0963 [email protected]

Spencer-Van EttenAge Color Sponsor Contact /Coach Phone Email6/7 Rodman's Kyle Lent 607-351-90748/9 Williams Nissan Dan Sutherlin 607-760-7026 [email protected]/11 Haefele TV Vincent Poole 607-259-9242

Tioga / NicholsAge Color Sponsor Contact /Coach Phone EmailKinder Orange Tioga Sanitary Service6/7 Forest Green Jim's Rv Seth Perry 607-259-01906/7 Navy Blue Tioga Sanitary Service AJ Sindoni 607-259-7738 [email protected]/9 Yellow Watson Cpa Ellen Feeko 607-687-90668/9 Neon Orange Tioga Downs DJ VanDusen 607-398-40578/9 Green Cc Logging Steve Zwierlein 607-972-3041 [email protected]/11 Lime Green Cooleys Kickers Larry Luther 607-972-6280 [email protected]/11 Black Harry Tufts Publick House Joe Rafferty 305-749-8387 [email protected]/11 Purple Aback Photography Ray Vough 607-259-8891

Tioga Sanitary Lime Green John Pipher 607-429-9360 [email protected]

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Newark Valley Fields

Driving North on 38: The fields are located approximately 1 mile from downtown Newark Valley traffic lights on right hand side. Looks for the Farmstead Museum on your left. If you get to the traffic light for the entrance to Newark Valley High School you have just passed the fields.

Driving South on 38: The fields will be on your left just after the traffic light for the entrance to Newark Valley High School.

BEMENT BILLINGS

FARMSTEAD

On NYS Route 38 North of Newark Valley

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Owego Fields

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Tioga/Nichols Fields

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Game Day Tips for Coaches

1. 1. ALWAYS confirm time, location and shirt color (for adequate contrast) with opposite coach. This will maximize the chances the other team will arrive in the right spot at the right time so you can play For out of town coaches, start trying to call on Monday. If you are traveling out of town, YOU contact the other coach to make sure you agree on what field, time, and how to get to that field. I’ve had 6/7 teams travel 35 minutes only to find the other team disbanded, because our coach didn’t bother to call. Don’t do that to your players and families. If you can’t contact the coach by Wednesday, call your player agent. We can get a message through.

2. Home games: - arrive at field at least 20 minutes early - welcome visiting coach and introduce yourself - point out the bathroom or port-a-john - bring only 3 balls, no personal balls - they only get lost; assign a parent to collect and guard balls during game

3. Away games: - it’s good to go as a caravan - if someone is going to the game but not in the caravan, have them tell you so you don’t wait endlessly for them - know who to expect at the meeting place. There are almost always enough drivers - xerox maps for all drivers - plan to leave early; you will probably get lost - if you’re not sure where you’re going, ask your Player Agent.

4. Getting focused on game day - warm ups, stretching BEFORE hard kicks - do a kick and run drill in the last 1-2 minutes - run, pass and shoot is a good warm-up

5. Plan in advance who is playing which quarters. Write each kids’ name on a small slip of paper and pick who is going to be OUT each quarter, then arrange the others - start with a strong defense, put your best players back, your good runners (or weakest) in the middle, strong scorers up front. You can always rearrange them, but you know who is in/out that quarter.

6. Pick 2-3 captains for each game. Record this on your paper saying who plays which quarters. Rotate every kid into the captain spot over the season. Keep your record because they will forget and accuse you of never making them captain.

7. After the game, record how many quarters each kid played. They all get roughly equal playing time over the course of the season. You need to do this to keep yourself honest. This is rec league and we play them equally, even if it means we lose.

8. During the game you will see what they need to work on. Use those notes to yourself to plan your practices.

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General Team Management Tips

Emphasize the positive. Comment on everything they do right. Try to structure practice drills and games so they are win/win. Divide into two very even groups or match evenly in pairs by ability. Try to end your exercise on a tie. Young kids trying real hard are not good losers. Manipulate the time limit so their practice drill/games come out as a tie, at least some of the time.

Don’t get too competitive within your team or you will have fights and tears.

Participation is the goal, getting every kid involved, no waiting in long lines. Try to structure everything so all kids are immediately involved. The first 10-15 minutes should be “fun games” that late kids can easily join in, that also work as warm-ups.

Use your helping parents. Get an exercise going, then send half your players with an assistant to do the same thing at a distance. OR have 2 or 3 stations with different activities at each. Kids rotate and adults stay put.

If you want them to listen, run them hard for 10 minutes. Take a brief water break or catch your breath break. Talk then. They only listen for 1-3 minutes. Their ball needs to be still while you are talking.

If you see something they need to learn but don’t know how teach it, call your Player Agent. We can help.

Insist that they show respect at all times. That means they do not talk while you are talking. I pretty much discipline only for lapses of respect - to me or a team mate. Use time out if you have to.

We have game hand-outs, booklets and web sites we can share.

Rick Kuklish

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Team Rules1. On time for practice, both players and coaches.

2. On time for a game: this means 15 minutes early to warm up and get focused.

3. NO put-downs of teammates!! Say only encouraging words like, “Good try” or “You’ll get it next time.”

4. Show respect for yourself, coach, teammates, and officials.

5. If you can’t make a practice, please call me to get the announcements.

6. If you can’t make a game or you will be late to a game, please let me know IN ADVANCE, if possible.

Parent Rules

1. The referee is ALWAYS RIGHT (even when he’s wrong.) No one argues with or questions his call.

2. Yell only positive things or DON’T YELL AT ALL! Please don’t yell playing directions to players. Let the coach do that. Too many voices yelling directions is very confusing to players.

3. For away games, players and drivers will meet at the Spencer tennis courts and go as a team. If you plan to drive but NOT meet at the tennis courts OR if your child will not play that away game, please let me know IN ADVANCE, so we don’t wait and wait for you.

4. Soccer is a team sport. Parents are also an important part of the team, as your support is crucial to your child’s success. Your young player needs help to keep track of his ball, shin guards, team shirt, water bottle, etc. Please plan on staying for the practice if you can. I need helpers.

5. If you can’t stay, please arrive 15 minutes before practice is over, GET OUT OF THE CAR, and be present to hear the announcements and get hand-outs. This is VERY IMPORTANT. Same for post-game announcements on Saturdays.

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Developmental Notes about Kinders – What I learned in previous years!

1. These kids have been working their entire life to learn how to share and take turns. The soccer ideas of “steal the ball from someone” or “try to keep it as long as you can” are counter to all this training. You may have some tears and complaints that “They’re not sharing! They won’t let me have a turn with the ball….”

Suggestion: don’t play too many aggressive games where you pit kids against one another for possession of the ball. Competition at this age doesn’t go over well, as they don’t lose well. What works is everyone working on the same thing at the same time, such as dribbling around from goal to goal and shooting ball thru, or from cone to cone and shooting to hit the cone and knock it over. Or tag-type games where when you’re tagged you also become it and get to keep playing. Or general games, like all players trying to creep up on the monster to steal balls without waking him up…

2. Kinders may get attached to “their” ball, especially if it has some identifying color, mark, or their name. Any game where they run to a new ball or someone gets their ball may cause tears.

Suggestion: Begin by explaining that in this game they will trade balls for a SHORT while. At the end, they will get their own ball back. Make sure the next game they can keep their own ball.

3. Kinders do not understand boundary lines. If they are playing hard, lines are invisible and meaningless. If the ball goes “out of bounds” they take no notice and just keep going after it until an adult stops them. Their playing field, in their minds, is the entire open space around them.

Suggestion: play lots of open games (Eg, tag) and do not require much staying inside of lines. IF you do some things inside a box or circle, use MANY discs to mark your lines clearly AND station parents all around like a “bungee fence” to direct them back into the playing space. If you mark off a space, be sure to do lots of other “open space” games to counteract possible frustrations. Also, games that have one line only – to approach or cross, are easier for them to grasp.

4. Don’t even bother to try and play more than a 2v2 game. Make wide cone-goals. I found that if I played a 3v3, they mowed one another down as they charged around like raging bulls. The whole idea of a rectangle with a goal at both ends makes no sense to them.

Suggestion: If you want to try a tiny game, make it two kids and one parent per team. Have the parents make gentle passes to them, show them which way to run, and how to defend the goal by getting ahead of the one with the ball. Group like-levels of athleticism together, so they all have an even chance to get to the ball. Even better, put a goal on each side and let anyone score anywhere. Or divide them in half and have one person for each goal to defend it for 3 minutes, then switch attackers and defenders.

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5. Kinders can barely score a goal when they stand right in front of it with no defender present. So, design games that have lots of rewarding moments. They won’t get many from scoring in the traditional sense.

This is a delightful age, but has its unique level of maturity. Work with where they are in their development, not against it. My Kinders ended up loving soccer last year, which was rewarding and fun for all of us. It was a learning experience for me, too!

Parents are most apt to hang out at this age, so recruit them to help and look for future coaches in their midst. If your group is small, work with them as one unit and do at least 4 to 5 different activities in your hour together. If it’s big, wonderful! Set up stations and do different things at each one. Have a parent run each station. Alternate running and restful stations. Have the kids rotate thru and parent-helpers stay put.

The easiest way to set up the stations is to have them planned. Take everyone to the first one, demonstrate and get it going. Leave a parent and group there. Take the rest and repeat at station #2. Their attention span is limited. 5 minutes of running will tire them out. More restful activities, if it’s one they like, can go for up to 10 minutes. Change stations until everyone has done everything. Then, set up 2 or 3 more and repeat.

Observe which stations the kids really like. The next time you do stations, an experienced parent who helped the time before can set that one up and get it going while you work on something new.

My second year doing Kindersoccer I took a different approach that worked well. I announced that Kindersoccer was family “together time” - a parent/child activity and set many large group activities up where the player and parent worked together as a pair. We started with very easy things - parent throws ball out and child runs to it and dribbles back. They loved that! Add variations: dribble back and then kick ball to parent when close, or kick thru parent’s legs. Over time I moved to using parent-partner activities mostly for warm-ups as people arrived, but it was a good way to work with them.

Don’t worry about making mistakes in planning. Kids will cry and that’s normal. Usually, they bounce right back if Mom or Dad is sup portive but not TOO sympathetic. Learn from your kids. Observe what they enjoy, how long they can last at an activity, what works and what doesn’t. In general, if you are warm and friendly and encouraging, they will do fine. If they don’t, they may not be ready for this kind of activity. That’s ok, too. Let them watch and try as much as they feel comfortable doing.

I had 3-year-old siblings plunging in and joining the crew while some older kids just couldn’t handle the ball-hogging aspects of trying to keep or get possession. Try to maximize a positive experience for eve ryone and yourself. Keep it to an hour and don’t forget to have fun!

Sally Marx

PS – Much of this also applies to 6/7’s!

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4x4 Playing Rules for Spencer, Candor, Tioga/Nichols, Newark Valley

Law I – The Field: Dimensions: Markings:

Goal:

30x20 yds (or 35x25), marked as follows: Halfway lineCenter circle: 5-yard radius Corner arc – 2 ft. radiusGoal Area – 5 yards out parallel to endline, 3 yds. out towards corner from each goal post. Goal – pop up style or something 6 ft. wide. Can use corner flags to mark height of goal if neededOr – a bare bones field has just an outline or parts of an outline if you’re on a field lined for an older age group. Small orange discs can be use to outline the field, mark a half way line and mark a distance out for goal kicks. U8 Travel Soccer often did this when I had a U8 team. (Sally)

Law 2 – The Ball: Size 3Law 3 – Number of Players: 4 max; 3 minimum; opposing team will drop to same number

and/or share players so all get to play. Maximum # on roster is 12. On game day, players divide into 2 small teams, not to exceed 6 players each. NO GK!! Sub on any dead ball or injury, TCYSA Policy: all players get equal playing time!

Law 4 – Players’ Equipment shin guards are mandatory, soccer sox and uniform shirt provided by league; sneakers or molded cleats.

Law 5 – The Referee certified ref not required. Coaches can officiate. Object is to keep the playing environment fun and safe, keep time, enforce rules, stop and restart play. When play is stopped, the official will explain why in a kindly manner. A single referee is adequate supervision. (The big issue for kids at this age is getting their turn. You can go alphabetically or by some other system, so they know they will get a turn.)

Law 6 - Assistant Referee Not usedLaw 7 – Duration of Game A game shall have 2 halves of 10 minutes each with a half-

time break of 3 minutes. On game day, each player will play in two games. The opposing team may rotate for the second game – or not, as the coaches choose. This structure may be modified if both coaches agree, depending on numbers and player strengths. Sharing players is encouraged, if one team is short.

Law 8 – The Start of Play The Away Team will kick off; Home Team chooses which end to DEFEND. Kick off is Indirect. Opponents must be 5 yards off the ball.

Law 9 – Ball In and Out of Play According to FIFA

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Law 10 – Method of Scoring According to FIFA

Law 11 – Offside No offside in 4x4Law 12 – Fouls and Misconduct Conform to FIFA, with one exception: Penalty for ALL fouls

is Indirect Free Kick, Opponents 5 yards off ball. Official will explain ALL infractions to offending player. Coaches need to stress “play the ball, not the man” and playing under control.

Foul in the Goal Area: If defending team gets the kick, ball can be placed anywhere in the goal box. (Usually placed on goal box line.) All rules for goal kick apply. If attacking team gets the kick, ball is placed on goal box line, in line with where the foul occurred. Defenders must be 5 yards away from ball (which means they will be on the goal line. They can stand inside the goal – that’s ok.

Law 13 – Free Kicks All free kicks are Indirect, opponents 5 yards off the ball; 2nd touch rule will be enforced. (Kicking player may not touch ball after kicking until someone else touches it – teammate or opponent.) Instruct players on a free kick to “pass the ball to a teammate.” (Ball must go slightly forward on a kick-off, however.) If player does do a 2nd touch, they get one re-try to do it correctly. If they do a 2nd touch again, the other team gets the ball for a free kick.

Law 14 – Penalty Kick No penalty kicks in 4x4Law 15 – Throw-In Replaced by a kick-in. Awarded when ball COMPLETELY

crosses sideline. Place within one yard of where it went out. Ball must touch line. Kick-in is Indirect, with opponents 5 yards off the ball.

Law 16 – Goal Kick Goal box at the 5-yard line is marked. Goal Kick may be taken from anywhere within the goal box, including on the line. Defenders may be in the goal box; attackers must be outside the goal box and 5 yards off the ball. Ball must clear the box to be in play. No one touches the ball until it does clear.

Law 17 – Corner Kick Like all free kicks in 4v4, this is Indirect. Opponents must be 5 yards away. Instruct kicking player to “pass to a teammate!” to avoid 2nd touch.

In general – if the two coaches agree on any modifications and explain them to the kids, it’s OK! The idea is to have fun, learn some soccer, and get fit! Be sure you have these rules with you

in case of a question.

TCYSA asks opposing coaches/players to shake hands after each game Have your team captains thank the official for refereeing their game

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INJURY REPORTING FORMS

ATTENTlON COACHESIf there are accidents or injuries please complete the

TCYSA Injury Report Form, and give it to your Player Agent, so they can mail to the TCYSA

President, Sally Marx.

Have the player’s parent or guardian complete the NYSW lnsurance form if they might seek

medical attention for the injury.

Links to the NYSW Insurance Forms and Information:

Claim Form:http://www.nyswysa.org/docs/InsuranceInfo/NYW_claimform_2017-18.pdf

General Information:http://www.nyswysa.org/docs/InsuranceInfo/NYW_Outlines_1718.pdf

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TCYSA INJURY REPORT

Date of injury: ___________________________________ Time of injury: ___________________________________ Location where injury happened: ____________________________________________________________________

Name of injured: _________________________________ Telephone Number: _______________________________ Address: __________________________________________________________________________________________City: ____________________________________________ State: _______________ Zip:________________________

Description of injury: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What happened: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Was immediate First Aid given? __________ Yes __________ No Describe First Aid Given: _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Who gave First Aid? _______________________________________________________________________________ List others involved: _______________________________________________________________________________

Did the injured player return to the soccer activity? __________ Yes __________ NoWas the parent/guardian informed? __________ Yes __________ NoTransportation from soccer activity? __________ Yes __________ No

Name of person completing this record: ______________________________________________________________Date of record: ________________________

Please Mail to: Rick Kuklish525 B East Main St. Apt.1Owego,NY 13827

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Risk Management Pass Information:

Last Name:_______________________________ First Name:__________________________ Middle Initial:_____

Birthdate: Month/Day/Year: ______/______/________ Gender: Male____ Female____

Street Address:________________________________________________ Town:__________________________

Mailing Address if different: __________________________________________________ Zip: ________________

Home Phone: (_____) ________________ Cell: (_____) ________________ Work: (_____) ________________

E-mail: ______________________________________________________________________________________







E-mail: ______________________________________________________________________________________







E-mail: ______________________________________________________________________________________

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