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Paper Registration - Fall Travel 2014 - Grades 3 - 8

Watertown Youth Soccer- Travel Teams Fall 2014(page 1 -2)

(BAYS.org Fall Travel teams are for children entering grades 3 through 8 in the Fall of 2014)

 

If you have internet access…DON’T FILL OUT THIS FORM

Click here and Register ON-LINE

Go to https://secure.adminsports.net/watertownmasoccer/

 

Travel Team registration deadline is June 8th for admittance to the Evaluation sessions scheduled for June TBD.


Late registration.  After June 8th, players are placed only if space is available.)

Registration questions can be directed to Robert Varnum, Tel#617-823-3687, email wystravelsoccer@gmail.com


 

 

A.Player Information - Name: _______________________________________ Boy __    Girl ____

 

Address: ______________________________________________Phone: _____________________ 

 

Email: ____________________________________________Date of Birth: ____________________ 

 

Grade: ___  School: ________________Current BAYS Team (if playing): ______________________

Current Jersey #________

 

B.  Registration Fee    (CIRCLE ONE):            Received                              Received

                                                                              by June 8th                          after July 1th

For Fall 2014 10 week season:                           $100                                       $145

           

C.UniformAll players must make a one-time purchase of the soccer kit. Each kit includes jersey, shorts and socks.  Please choose your player’s shirt and shorts size:

 

            Jersey  (circle size)   Youth:              Medium     Large   Extra-large

             $23.00                        Adult:  Small   Medium     Large   Extra-large

 

            Short    (circle size)   Youth:               Medium    Large   Extra-large

             $13.00                        Adult:  Small    Medium    Large   Extra-large

 

            Socks:  (circle size)   One size    Yes  /   No

             $6.00

D.On-time Registration and kit feesReg. Fee $100 + Kit  $42 = $142  Total enclosed$________

E.  Volunteer – we need you!  Watertown Youth Soccer is a volunteer organization.  Check your interest and we will contact you.

If you can be a:      ¨ Coach         ¨ Assistant Coach         ¨ Team Manager 

¨ Board Member                 ¨ WYS Organizational Helper

 

Name of volunteer(s):_________________________________________________________

 

Phone: _________________________________ Email: _____________________________

F.  General Publicity - I give permission to WYSL to take, use and publish photos and video images of the registered person participating in WYSL activities for purposes of general publicity relating to WYSL in any media format  ¨ Yes  ¨ No

                                

                                                       (Fill out reverse side.)    

 

 

 

 

         

Watertown Youth Soccer - Travel Teams Fall 2014  (page 2-2)

 

Player’s Medical/Emergency Information:

 

Player’s Name: ______________________________________ Date of Birth: ________________

Medical Problems? _______________________________________________________________

Person to notify in emergency_______________________________ Phone___________________

Doctor’s name___________________________________________ Phone___________________

Insurance carrier_______________________________ Policy number________________________

 

Consent for medical treatment of a minor: 

As 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 Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb, or well being of the registered player.

 

Injury Waiver; Confirmation of Rules: 

I hereby absolve the WYSL, including all coaches, managers, officers, and others participating in league activities from all liability and will not hold them responsible for injury incurred to the registered person, and hereby give my approval to this person’s participation in this league. I also agree on behalf of my family and the player that we will follow and abide by the rules and procedures of WYSL.  I acknowledge that WYSL and coaches have the authority to suspend registered players for poor behavior detrimental to the purpose of the league.

 

USYS/MYSA/BAYS/WYSL Release: 

I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of USYSA and its affiliated organizations and sponsors (including MYSA, BAYS and WYSL.)  Recognizing the possibility of physical injury associated with soccer and in consideration for each of USYSA/MYSA/BAYS/WYS accepting the registrant for its soccer programs and activities (the “Programs”), I hereby waive, release, discharge and/or otherwise hold harmless and indemnify each of USYSA/MYSA/BAYS/WYSL, its affiliated organizations and sponsors, their employees and associated personnel, 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.

 

Watertown Recreational Field Fees Participant Information:  I hereby permit WYS to provide the following information to the Watertown Recreation Department (WRD):  My child's name, date of birth, gender and address.  This information may be used by the WRD to bill families for an individual annual field use fee.  At the time this form was printed, the Town of Watertown had not yet authorized collection of any individual field use fees or Youth Organization Fees.  If the Town implements a Youth Organization Fee WYS will have to collect monies at that time from WYS members and would increase the amount each family will have to pay per player to WYS for the season.

 

Signing below indicates the acceptance of the terms of this agreement:

 

Print Parent/Guardian’s Name_________________________________Phone________________

 

SignatureParent/Guardian’s __________________________________Date__________________

 

Return completed form, with check to Watertown Youth Soccer, to:

Watertown Youth Soccer c/o Robert Varnum

121 Boylston St., Watertown, MA  02472

 

Travel Team registration due date is June 8th     

Registration may be refunded up to July 1st minus $25 which is WYSL’s insurance and administration costs per player.

After July 15, 2014 there are no refunds.

 

                                              (Fill out reverse side)

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WYSL Fall 2014 reg form_0.pdf224.38 KB