BAY AREA YOUTH SOCCER 2014-2015 REGISTRATION

Registration with Bay Area Youth Soccer (BAYS) is a binding agreement that the player has an obligation to complete their requirements as a registered member of Bay Area Youth Soccer (BAYS)

**Registration forms received after October 1, 2014 are considered late with no guarantee of team placement**

*NO REFUNDS WILL BE ISSUED!!! Special requests must be made in writing to the Board for approval*

PLAYER INFORMATION

Last Name ______First Name ______Middle Initial ______

Address______City ______Zip______

School ______Grade______Yrs of Experience ______

Date of Birth ______Gender (M/F) ______

Uniform Size: Shirt: YXS YS YM YL AS AM AL AXL AXXL Shorts: YXS YS YM YL AS AM AL AXL AXXL

PARENT INFORMATION

Father______Phone______Alt Ph______

Email ______

Mother______Phone ______Alt Ph ______

Email ______

Emergency Contact ______Phone ______

WE ASK FOR ACTIVE PARENT PARTICIPATION FROM ALL PARTENTS. PLEASE CIRCLE THE AREAS WHERE YOU CAN ASSIST IN THE DEVELOPMENT OF YOUR CHILD.

COACH ASST. COACH CONCESSION SPONSOR BOARD MEMBER REFEREE

PLAYER CODE OF ETHICS

I will conduct myself in a manner respecting the facilities, other players, referees, coaches, and administrative staff of B.A.Y.S. while I am taking part in any program under their tutelage. I also understand that if I am found to be using, in the possession of, or distributing drugs, alcohol, or any other deemed illegal item, that I will be expelled from the program. At such time, my parents will be responsible for making the necessary arrangements and bear all financial responsibility.

______

Signature of Player/Date Signature of Parent/Guardian/Date

PARENT’S/GUARDIAN’S APPROVAL AND MEDICAL RELEASE

Acknowledging the possibility of physical injury associated with playing soccer and in consideration for B.A.Y.S and its affiliates accepting your child for its soccer programs and activities, I hereby release, discharge and/or otherwise indemnify B.A.Y.S and its affiliates and sponsors, their employees and associated personnel, including the owners of the fields and facilities utilized for the programs against any claim by or on behalf of your child as a result of their participation in the programs. My child has received a physical examination by a physician and has been found physically capable of participating in the programs. I hereby give my consent to have an athletic trainer and/or doctor of medicine or dentistry provide my child with medical assistance and /or treatment.

______

Signature of Parent/Guardian/Date Health Ins. Carrier Policy Number

Please list any medical problems or required medications: ______

PLEASE RETURN COMPLETED FORM, COPY OF BIRTH CERTIFICATE AND PAYMENT TO:

Registrar: BAYS EMAIL:

PO BOX 3831

Bay St. Louis, MS 39521

Make checks payable to BAYS: U6 $65, U8-U19 $85 first child, $75 each subsequent child

***A $35.00 NSF Fee will be assessed for all checks that are returned due to Insufficient Funds. No refunds will be issued!!!!***