SPARTA SOCCER CLUB TOWN LEAGUE REGISTRATION FORM

Mail To: Sparta Soccer Club P.O. Box 232, Sparta, New Jersey

Spring 2008 fees ($40)1^st child ($37) 2^nd child, ($35) 3rd or more registered

(Pre-K must be 4 by 7/31/07) $20.00 LATE FEE applies after 3/1/08: Late Applicants accepted on a space available basis

Player Information:

Last Name

First Name

Middle Initial

New to Sparta Soccer

Yes or No Circle one

Address

Phone

( ) -

Sex

Date of Birth

Age

Grade

School

Previous Experience (# of Seasons played)

Height

Weight

Any Illness or Disability Coach should be aware of?

Parent/guardian name

work phone

( ) -

email

Parent/guardian name

work phone

( ) -

email

PLEASE VOLUNTEER TO HELP THANK-YOU! Please indicate which parent(s) can help.

**COACH or **ASST.COACH **LEVEL OF LICENSE OR CERTIFICATION ________________ IMPORTANT!

DIVISION DIRECTOR TEAM PARENT SPONSOR OTHER

Participation Rules of the Sparta Soccer Club:

· SSC offers an equal opportunity program. However, if any player, coach or parent displays serious problems that disrupt team practice and/or play, that player, coach or parent will be asked to leave the field.

· SSC does not allow any player to participate in the program while wearing a medical brace or cast without a medical release stating that it is safe for the player. If any such device may cause injury to another player during the natural course of play, it must be well padded and acceptable to the referee and coach.

· Players must remove jewelry, hair clips, etc. before play if deemed unsafe by the referee. Players with newly pierced ears must cover the area with a band aid.

· SSC requires that all players wear shin guards. No shin guards: no play! Orthopedic appliances should be guarded. Soccer cleats are strongly recommended.

· Pets are not to be at the field during games or practice.

· Soccer is a team sport and attendance at practice and games is important.

· Players can be rostered to either a recreation team or a travel team – not both at the same time.

Parent / Guardian Participation Agreement: I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the Sparta Soccer Club, (henceforth referred to as "SSC"), its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for the SSC accepting the registrant for its soccer programs and activities, I hereby release, discharge and/or otherwise indemnify the SSC, 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. Parent/Guardian Name _________________________________________ Signature _________________________________________Date

Consent for Medical Treatment (Minor) As the parent or legal guardian of the above-named player, I hereby give 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 the life, limb, or well-being of my dependant. I acknowledge that my child/ward is in good health and able to participate in the sport of Soccer. Parent/Guardian Signature:____________________________ Date ________________

Carpool Requests are not accepted

T-shirts provided for Pre-K – thru 2^nd grade Reversible Jersey needed for 3^rd grade & up (purchase if you don’t already have)

TO BE COMPLETED BY REGISTRAR:

DIVISION FEE CHECK# REP DATE

Girls Team Coed only Uniform Ordered Uniform paid Jersey size Sock size