YMCA – Brad Akins Branch

2017 Spring Soccer Timeline

  • Jan. 9– Feb. 6Youth Soccer Registration
  • Feb. 7 – 10 Late Registration (if available) $65 members/$95 nonmembers
  • Feb. 14Little Kickers/U6/U8 Coaches Meeting @ 6:30 pm
  • Feb.16U10/U12/15U Coaches meeting @ 6:30 pm
  • Feb. 21Little Kickers, U6, & U8 Parent orientation @ 6:30 pm

(All parents with children in Little Kickers, U6, & U8 age groups need to attend)

  • Feb. 23U10, U12, and U15 Parent orientation @ 6:30 pm

(All parents with children in U10, U12, and 15U age groups need to attend)

  • Feb.27Soccer practices begin. Mon, Tue, & Thurs practices @ 6 & 7 pm

(Coaches schedule practice time & date)

  • Week of March 20thSoccer games begin

(Coaches will have schedules)

U6 games played Fridays @ 6 pm or Saturday morning

U8 games played Thursdays @ 6 and 7 pm

U10 games played Fridays @ 6-7 pm or Saturday morning

U12 and 15U games played Fridays and Saturdays (possible away games)

  • TBASoccer Picture Day @ YMCA

(Coaches will schedule their team’s picture time)

  • April 17 - 21 Barrow County Spring Break

(No games or practices this week)

Brad Akins YMCA

2017Spring Soccer Registration

*PLEASE WRITE LEGIBLY*

(Circle one)

Name

/ First Last /

Male

/ Female

Address

City

/

Zip

Phone

/

Birth Date

/ / / Age

E-Mail Address

Additional Player Information

Number of Seasons Played /

Last Team

/

Last League and Date Played

Other Children in League / Name /
Age

Any Physical Problems We Should Know About?

Uniform Size

(Circle One) /

Shirt

YXS YS YM YL AS AM AL

AXL

Registration

Fee: /

Please Mark Correct Fee:

Member $55.00  Non-Member $85.00

SELECT correct AGE GROUP by child’s age as of August 1st,2016

□Under-12 (1-1-2005 to 12-31-2006) □15 and Under (1-1-2002 to 12-31-2004) Ages 10-11 Ages 12, 13, and 14

Under -10(1-1-2007 to 12-31-2008) Under-8 (1-1-2009 to 12-31-2010)

Ages 8-9Ages 6-7

Under -6 (1-1-2011 to 12-31-2012) Little Kickers $45 Member & $75 Non Member

Ages 4-5 (1-1-2013 to 12–31–2013)3 year olds

Father’s Name / Cell Phone: /

Bus. Phone:

Mother’s Name / Cell Phone: /

Bus. Phone:

COACH
/ ASSISTANT COACH / TEAM MOM / DAD / PHONE CALLS / FIRST AID KIT
*The YMCA Does Not Guarantee any Practice Time Request or Coaches Request! NO Refunds Will Be Given After Uniforms Have Been Ordered!*

Volunteer Opportunities (Circle One)

Participant Waiver

As a participant in programs offered through the Winder-Barrow Brad Akins YMCA for either myself or my child, the undersigned acknowledges and agrees to the following:

1.The YMCA is a Christian organization and that my child and I are expected to conduct ourselves in accordance with the teachings of Jesus Christ.

2.I give my permission to the Winder-Barrow Brad Akins YMCA for the use of photos and slides that may be taken of my child or of myself and to use, without limitation or obligation, photographs, film footage, or tape recordings which may include either my image or voice or the image and voice of my child for purposes of promoting or interpreting YMCA programs.

3.I understand the Winder-Barrow Brad Akins YMCA assumes no responsibility for injuries or illness which I or my child may sustain as a result of physical condition or resulting from participation in any athletic activities, sports programs, the use of any equipment, exercises, or other activities while on the property of or in conjunction with any activity held, coordinated or sponsored by the Winder-Barrow Brad Akins YMCA. In consideration of the privilege of participation at the YMCA, I hereby voluntarily release and discharge the Winder-Barrow Brad Akins YMCA, its officers, directors, employees, agents, and/or servants from any claims whatsoever, including for injury, illness, death, loss or damage which I or my child may suffer as a result of my/his/her participation in these activities. I understand that no accident or medical insurance is provided with these activities. I fully indemnify and hold harmless the Winder-Barrow Brad Akins YMCA, its officers, directors and employees from any and all claims.

4.I understand the Winder-Barrow Brad Akins YMCA is not responsible for personal property lost or stolen while members and/or program participants are using YMCA facilities, participating in YMCA activities, or on YMCA premises.

5.While the Winder-Barrow Brad Akins YMCA will make every attempt to provide reasonable accommodations for mentally and physically challenged children and adults, the YMCA will not accept children or adults that are (a) of danger to themselves, (b) of danger to others, or (c) a disruption to the normal activities making it unreasonably difficult for other children or adults to enjoy YMCA programs and activities. Any of the above reasons will be grounds for dismissal from YMCA programs and activities. We strongly recommend that you discuss with Winder-Barrow Brad Akins YMCA staff any special conditions or circumstances involving your child or an adult member in your household. We request that you do this PRIOR to registration so that we can advise you as to whether we can make a reasonable accommodation for your child or adult household member.

Acceptance

I have read and voluntarily signed this waiver and release of liability and indemnification agreement, and further agree that no oral representation, statements or inducements apart from the foregoing written agreement have been made. I also accept the Conditions of Membership as well as the conditions imposed upon participants, both youth and adult, in activities and programs provided by the Winder-Barrow Brad Akins YMCA.

______

Signature of Member/Participant Signature of Parent/Guardian Date