http://www.clarkstonsoccerclub.org
751-0329
OFFICAL USE
DIVISION
BC Y___N___
TEAM#_________
2008 FALL SOCCER SEASON
NAME_____________________________________AGE______BIRTHDATE_____________________
ADDRESS____________________________________________PHONE__________________________
E-Mail Address_________________________________________________________________________
CITY____________________________ZIP_______________________MALE______FEMALE______
Shirt Size_________ Short Size_______
The parent of the above named child hereby gives approval for their participation in any youth activity during the current season. We assume all risks and hazards incidental to such participation in the activities, and we do hereby waive, release, absolve, indemnify, and hold harmless the Clarkston Soccer Club, the Washington State Youth Soccer Association, and its employees, the organizers, sponsors, supervisors, participants, officials, and person transporting your child except for the amount covered by accident or liability insurance. I agree to fill out and sign a Medical release form, and a Uniform return policy form, and return it to my child’s coach. In addition we agree to abide by the Clarkston Soccer Clubs rules and code of conduct. Players and Parents agree to pay all forfeit fees charged to the Clarkston Soccer Club, if your child is not present at the game, and causes a forfeit. That fee is currently set at $750. Parents will be billed $100 replacement cost for each uniform piece if any part of a club uniform (except socks) is not returned at the end of the season. The Player also agrees to participate in all Fund-Raising activities by the Clarkston Soccer Club. If not I understand my Players Fee will raise to a more substantial level to cover the costs. This could be as much as an additional $100 above the current fee.
PARENT/GUARDIANS SIGNATURE______________________________________DATE___________
Fall Season Player Fee $90 / Fall and Spring Season Fee $150
Option #1 $90.........Player Fees only /Fall and Spring Season Fee $150
Option #2 $110.......Includes Player Fees and T-Shirt with Logo / Fall and Spring Season Fee $170
Option #3 $125.......Includes Player Fees and Sweatshirt / Fall and Spring Season Fee $185
Option #4 $140.......Includes Player Fees, T-Shirt, and Sweatshirt / Fall and Spring Season Fee $200
*XXL and XXXL sizes are an additional $2.00
Check Appropriate ones
Sweatshirt Color: Black___ Red___ Size: Small___ Medium___ Large___ Extra-Large___
T-Shirt Color: Black___ Red___ Size: Small___ Medium___ Large___ Extra-Large___
CLARKSTON SOCCER CLUB IS AN ALL-VOLUNTEER ORGANIZATION. WE NEED YOUR HELP AND SUPPORT!
Please Check appropriate ones:
Board Member___ Field Maintenance____ Fund Raising___ Coaching___ Score- Keeper___ Sponsor___
IF YOU CAN NOT VOLUNTEER, PLEASE HELP US WITH A CONTRIBUTION ABOVE THE PLAYER FEE. You will be added to our Sponsors page on our web site.
Total Amount Enclosed $_______