High Bridge Youth Soccer Registration Form

Child's First Name:

Parent/Guardian First Name:

Last Name:

Street Address:

City: State: Zip:

Home Telephone:

E-Mail:

Grade in Fall 2010: Kindergarden 1st Grade 2nd Grade 3rd Grad 4th Grade 5th Grade 6th Grade 7th Grade 8th Grade

Gender: Select One Male Female

Child's Birthdate(mm/dd/yy):

Child's Height: Child's Weight:

Has your child played in HBYS before? Select One Yes No

Does your child play on any other organized soccer league? Select One Yes No

If you are registering 2 or more players in the same division, do you want them on the same team? Select One Yes No

Additional Children Being Registered. Please include the grade they are going into this fall:

To coach, assistant coach, or volunteer in any form, please compete our VOLUNTEER REGISTRATION FORM. Without volunteers, the league does not exist.

By submitting this form, you, the parent or guardian of the said individual, who is in good physical health and has no abnormalities, hereby give my consent to play in the High Bridge Youth Soccer League (HBYS) and agree to release, indemnify and hold harmless HBYS officials, coaches and representatives from any claim arising out of injure to the above named individual.