2005 Youth
Fall Soccer Program

Open to all South Plainfield boys and girls ages 6 - 13 as of October, 2005.

Fee: $35 per participant. Fee is not refundable
Registration period begins June 7, 2005 and ends August 20, 2005.

 

The program begins on Saturday, September 17th  All games are played on Saturdays.
You must be registered to play

Soccer Player.jpg (15282 bytes)

Register at the Recreation Office, located in the PAL Recreation Center,
1250 Maple Avenue,  Monday through Friday, 8:30 a.m. to 5:00 p.m.
The Recreation Office will also be open from 6:00 - 8:00 p.m. on
the first and third Mondays of every month. OR Print out this form and mail
with a proof of residency along with a check made out to "South Plainfield Recreation". 
Birth Certificates are required for registrants who have not previously
participated in a Recreation sponsored Youth League.

Please Print

Name:

 __________________________________ Check: Boy_ Girl_

Address:  

__________________________________

Phone #:

 _________

School Attending:  

__________________________________

Age (as of 10/1/05):

 _________

Played Travelling Soccer:   Yes___   No___

League Played in 2004 (please circle league)

D
(Age 6)		 C (Ages 7-8) B (Ages 9-10) A (Ages 11-13) First Time Player Did not play
in 2004

Please circle t-shirt size:

Youth Large Adult Small Adult Medium Adult Large Adult XL


PARENTS, please read before signing: NO REFUNDS
I understand that physical risks are involved in my child's/ward's participation
in the South Plainfield Recreation Department Youth Soccer Program. I understand
that these risks may range from minor bruises to life threatening injuries. I have
made my child/ward aware of these risks and, by allowing him/her to participate in
this program, hereby affirm that I fully assume responsibility for these risks.
My signature below confirms that I have read and am in agreement with these statements.

Parent/Guardian Signature:___________________________________ Date:_________________
----------------------------------------------------------------------------------------------------------------------------------------------------------------------
Parents:  If you wish to coach please let us know:  ________Coach   ________Assist

Name:_____________________________________________________________________
Home Phone:____________________________  Work Phone:________________________
Preferred Age Group: (circle):   D(6)     C(7-8)    B(9-10)   A(11-13)