Central Okanagan Youth Soccer Association

2016-17 INDOOR SOCCER REGISTRATION FORM

For players born 1999-2010 - all skill levels - 17 weeks

Friday, October 21, 2016 to Sunday, March 12, 2017(no sessions December 16 to January 07)

$125.00 (cheque or money order ONLY, payable to COYSA). NO CASH please (sorry, no credit cards)

Cheques may be posted dated no later than September 30, 2016

NO REFUNDS AFTER October 15($25.00 fee charged on all refunds. Requests must be in writing to )

Please drop off or mail registration and payment to address below.First come, first served.

Limited number of spaces available.Do not wait for final deadline of SEPTMEBER 30.

NO PHONE CALLS AND NO REQUESTS PLEASE. Email all questions to:

First Name: Click to enter first name Last Name: Click to enter last name

Date of Birth: (month)Click to enter month (day) Click to enter day (year)Click to enter year Gender:Click arrow to choose MALE or FEMALE

Phone Number: Click to enter phone number Address: Click to enter street address

City: Click to enter city Postal Code: Click to enter postal code Email: Click to enter PARENT email

School: Click to enter 2016-17 school

U11-18 (2006-1999)for outdoor soccerdid you play:Click arrow to choose Div A | Kelowna United | TOFC | Other If Other:Click to describe

Skill Level: Click arrow to choose 1 (strong) | 2 (average) | 3 (still learning / beginner)

Are you a Goal Keeper: Click arrow to choose YES or NO If YES: Click arrow to choose part-time or full-time

Coaches are needed to run the league: Are you willing to coach your child’s team? Click arrow to choose YES or No

We cannot accept co-coaching requests at this time.

A Criminal Record Check is required - if you coached outdoor, we can get it from the Club.

2009/2010 (U8) CO-EDchooseTuesday 4:00-4:50pm | Wednesday 4:00-4:50pm | Tuesday 5:00-5:50pm

(if no choice is made, will be placed where there is space)

Click arrow to choose Tuesday @ 4:00pm | Wednesday @ 4:00pm | Tuesday @ 5:00pm

Print Parent / Guardian Name: Click to enter parent/guardian name Today’sDate: Click arrowto choose from calendar

I wish to receive information via email from COYSA Clubs about outdoor registration, camps, tournaments etc:Click arrow to choose Yes or No

Signatureof Parent or Guardian: ______

I hereby release and forever discharge Central Okanagan Youth Soccer Association (COYSA) its authorized agents, employees and representatives from any and all causes of action, claims damages, loss or injuries of every nature and kind, howsoever arising, which I or the particular ever had, now has (have) or may hereafter have as a result of participation in this program.

International Students are not eligible to play in this league (FIFA rule).

COYSA: #206 - 1415 Hunter Court, Kelowna, B.C. V1X 6E6

Website: Email:

If the main doors of the building are locked, an envelope will fit between the doors!

2016-09-01