Registration Deadline is July 31, 2018 - Lakewood...
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Fall 2018 Saturday Soccer Membership Form Full Name: __________________________________________________________________ Birth Date: ______/______/______ Gender (circle): M F School: _________________________________ Grade on Sept. 1, 2018 ____________ Last team this child played on: _____________________________________________ Coach or friend request: _____________________________________________________ Does this player also play LUFC travel or club soccer (circle)? Yes No Player #1 Please print clearly. Parent or Guardian Information Address: _____________________________________________________________________ City/State/Zip: _______________________________________________________________ Parent/Guardian Full Name: ____________________________________________________________________________________________________________________________________ Email: ________________________________________________________________________ Best phone # to reach you: __________________________________________________ Consent to Play and Waiver - parent or guardian must sign I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the Lakewood Soccer Association (LSA). Recognizing the possibility of physical injury associated with soccer and in consideration for the LSA accepting the registrant for its soccer programs and activities (the “Programs”), I hereby release, discharge and/or otherwise indemnify the LSA, their employees, associated per- sonnel and board members, including the owners of fields and facilities utilized for the Programs, against any claim by or on behalf of the registrant as a result of the registrant’s participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize. Required Support Signature: _________________________________________________________ Date: ___________________ LSA is a volunteer organization. We require active participation of all members to keep fees down. Please check one area in which you can help. We always need coaches! Lindsay’s Law - Sudden Cardiac Arrest Lindsay’s Law - (Ohio Revised Code 3313.5310, 3707.58 and 3707.59) went into effect Aug 1, 2017 applicable to all youth sport organizations. All participants and their parents are required to view the video (16 minutes) and read the material contained at the following link: https://www.odh.ohio.gov/en/la nding/Lindsays-Law ‘Lindsay’s Law’ r By marking this check box, I, the parent/guardian of the participant, confirm that I have viewed the video and read the material regarding Sudden Cardiac Arrest contained in the above link. r By marking this check box, I, the parent/guardian of the participant, confirm that the youth participant has viewed the video and read the material regarding Sudden Cardiac Arrest. r Coach/Assistant Coach r Team Manager r Field Preparation/Set-up r Equipment Trailer Pulling r Concession Stand r Board Member Registration Deadline is July 31, 2018 Registration Fee Spring..................................................................$50 Late fee...............................................................$20 (if postmarked after July 31, 2018) LUFC players receive a 50% registration discount. Total Amount Paid $______________ Check # __________________ or Cash Make checks payable to Lakewood Soccer Assoc. Mail completed form and check to: P.O. Box 770701; Lakewood, Ohio 44107 Or drop off at: 1447 Lewis Dr., Lakewood, Ohio (attn: Registrar) After deadline, registrations will be taken with a $20 late fee. There are NO TEAM REQUESTS after the deadline. Register with check or cash with this form, or register with credit card at www.lakewood-soccer.com Full Name: __________________________________________________________________ Birth Date: ______/______/______ Gender (circle): M F School: _________________________________ Grade on Sept. 1, 2018____________ Last team this child played on: _____________________________________________ Coach or friend request: _____________________________________________________ Does this player also play LUFC travel or club soccer (circle)? Yes No Player #2 (If you are registering more than two children, please use an additional form.) Team Assignment Notification: the Week of Aug 17 Schedule of 8 Games will Begin Aug. 25 Uniforms can be purchased at Geiger’s More information at www.lakewood-soccer.com
Transcript of Registration Deadline is July 31, 2018 - Lakewood...
Fall 2018 Saturday Soccer Membership Form
Full Name: __________________________________________________________________
Birth Date: ______/______/______ Gender (circle): M F
School: _________________________________ Grade on Sept. 1, 2018 ____________
Last team this child played on: _____________________________________________
Coach or friend request: _____________________________________________________
Does this player also play LUFC travel or club soccer (circle)? Yes No
Player #1 Please print clearly.
Parent or Guardian Information
Address: _____________________________________________________________________
City/State/Zip: _______________________________________________________________
Parent/Guardian Full Name: ____________________________________________________________________________________________________________________________________
Email: ________________________________________________________________________
Best phone # to reach you: __________________________________________________
Consent to Play and Waiver - parent or guardian must signI, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the Lakewood Soccer Association (LSA). Recognizing the possibility of physical injury associated with soccer and in consideration for the LSA accepting the registrant for its soccer programs and activities (the “Programs”), I hereby release, discharge and/or otherwise indemnify the LSA, their employees, associated per-sonnel and board members, including the owners of fields and facilities utilized for the Programs, against any claim by or on behalf of the registrant as a result of the registrant’s participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize.
Required Support
Signature: _________________________________________________________ Date: ___________________
LSA is a volunteer organization. We require active participation of all members to keep fees down. Please check one area in which you can help. We always need coaches!
Lindsay’s Law - Sudden Cardiac ArrestLindsay’s Law - (Ohio Revised Code 3313.5310, 3707.58 and 3707.59) went into effect Aug 1, 2017 applicable to all youth sport organizations. All participants and their parents are required to view the video (16 minutes) and read the material contained at the following link:
https://www.odh.ohio.gov/en/la nding/Lindsays-Law ‘Lindsay’s Law’
r By marking this check box, I, the parent/guardian of the participant, confirm that I have viewed the video and read the material regarding Sudden Cardiac Arrest contained in the above link.
r By marking this check box, I, the parent/guardian of the participant, confirm that the youth participant has viewed the video and read the material regarding Sudden Cardiac Arrest.
r Coach/Assistant Coach
r Team Manager
r Field Preparation/Set-up
r Equipment Trailer Pulling
r Concession Stand
r Board Member
Registration Deadline is July 31, 2018
Registration FeeSpring..................................................................$50 Late fee...............................................................$20(if postmarked after July 31, 2018)
LUFC players receive a 50% registration discount.
Total Amount Paid $______________
Check # __________________ or CashMake checks payable to Lakewood Soccer Assoc.
Mail completed form and check to: P.O. Box 770701; Lakewood, Ohio 44107
Or drop off at: 1447 Lewis Dr., Lakewood, Ohio (attn: Registrar)
After deadline, registrations will be taken with a $20 late fee. There are NO TEAM REQUESTS after the deadline. Register with check or cash with this form, or register with credit card at www.lakewood-soccer.com
Full Name: __________________________________________________________________
Birth Date: ______/______/______ Gender (circle): M F
School: _________________________________ Grade on Sept. 1, 2018____________
Last team this child played on: _____________________________________________
Coach or friend request: _____________________________________________________
Does this player also play LUFC travel or club soccer (circle)? Yes No
Player #2 (If you are registering more than two children, please use an additional form.)
Team Assignment Notification: the Week of Aug 17 Schedule of 8 Games will Begin Aug. 25
Uniforms can be purchased at Geiger’s
More information at www.lakewood-soccer.com
The Lakewood Soccer Association . . . A volunteer, non-profit organization serving the community since 1982.
Fall 2018 Saturday Soccer Lakewood Soccer Association
• Cost
o Spring Season - $50; sign up at www.lakewood-soccer.com starting June 1, 2018, or send in a paper form now. The registration deadline is July 31, 2018. Team requests made after that date will not be considered.
• Eight-week season starts August 25, 2018. Games are played in the Metroparks at Memorial
Field on Saturday mornings, at four time slots: 8:30 a.m., 9:45 a.m., 11 a.m. and noon. • Uniforms are available at Geiger’s and are not included in the registration fee. • Each player will get team and coach information EMAILED to them during the week of August 17. • Players will be assigned to teams based on the age guidelines listed below. Players may
play with their grade level if it is different then their age group.
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Jan-July U14 U13 U12 U11 U10 U09 U08 U07 U06 U05
Aug-Dec U14 U13 U12 U11 U10 U09 U08 U07 U06 U05
• Age Divisions. U5 through U9 will be single-year age divisions as in the past. U10 and U11 will be combined. U12, U13 and U14 will be combined.
• Refunds will be made prior to Game 1 upon request minus a $20 admin fee.
Please complete the registration form on the reverse side of this flyer and mail it to the LSA P.O. Box listed at the top of the form. Questions? Check our website: www.lakewood-soccer.com.
Registration deadline is July 31, 2018.
All forms postmarked or received after July 31, 2018, will have a $20 late fee added. NOTE: Team placement is not guaranteed and is based on availability.
It’s Always Kickin’ at Lakewood Soccer!
There are two in-person registrations set for July 2018 Information is on our website, www.lakewood-soccer.com
Saturday, July 14, 3-5 p.m. Madison Park Futsal Courts
Saturday, July 28, 3-5 p.m.
TBA-Please see the LSA website for location
