2013 Enon Soccer Registration

Please fill out the form below and send a check for $65 ($5 discount for each child thereafter) made out to Enon Soccer, along with the Reference Number/Page generated after you submit this form to PO Box 173 Enon, OH 45323

Player Name:
Player Address:
City:
Zip:
Email:
Phone:
Alternate Phone:

Boy Girl

Player Date of Birth:

Any special comments or medical conditions?

Are you planning on sending your child to the 2013 Columbus Crew youth development soccer camp?
(cost is an extra $60)

Yes No

Uniform Size:
Shorts
Shirt

Are you planning on trying out for Select Soccer?
Yes No

Number of years playing soccer:

Parent/Guardian Name:

Consent to Publish Photos:

I hereby grant Enon Soccer permission to publish photos of the SAY Soccer season, which may include pictures of my child. No names would be used and I understand that every attempt will be made to prevent unauthorized access to online information and hold SAY Soccer harmless for the accidental dissemination of information.
I agree I disagree

Consent for Emergency Medical Treatment:

WE GIVE PERMISSION FOR EMERGENCY MEDICAL TREATMENT FOR OUR CHILD FOR ILLNESS OR ACCIDENT IF WE CANNOT BE CONTACTED.
I agree I disagree

BY SUBMITTING THIS FORM WE HEREBY AGREE THAT THE SOCCER ASSOCIATION FOR YOUTH (SAY) ITS MEMBERS, COACHES OR OFFICERS SHALL NOT BE LIABLE FOR ANY INJURY OR LOSS WHICH MY CHILD MAY SUSTAIN WHILE PARTICIPATING IN ACTIVITIES OF ANY KIND WHETHER SPONSORED BY OR UNDER THE SUPERVISION OF SAY AND WE AGREE TO INDEMNIFY AND HOLD HARMLESS SAY, ITS MEMBERS, COACHES OFFICERS OR DESIGNATES OF ANY KIND FROM ANY CLAIM WHATSOEVER.

I ALSO AGREE TO PAY $65.00 FOR MY CHILD TO PLAY WITH ENON SOCCER ($5.00 DISCOUNT FOR EACH ADDITIONAL CHILD IN THE SAME FAMILY). I ALSO AGREE THAT IF MY CHILD IS UNABLE TO PLAY, NO REFUND WILL BE GIVEN UNLESS NO EXPENSES ON BEHALF OF ENON SOCCER HAVE BEEN INCURRED.