SOCCER 2021

Soccer is offered to Kindergarten thru 5th grade. It is split into three grade levels. Kindergarten (plays 4 on 4), 1st and 2nd (plays 6 on 6), and 3rd thru 5th (plays 9 on 9). Practice will tentatively begin the week of April 5th, 2021. Teams will practice twice a week in the evenings. Games will be played during the week and a jamboree on one Saturday.

Volunteer coaches are always needed as we have many soccer participants. If you have an interest in volunteering as a coach, or referee, please call the Park and Rec office or check the box on this form. Deadline to sign up will be August 28th. $25 before deadline, $35 after

Registration Options

Option 1 ($25.00)

Grade

Date of Birth

Name

Phone Number

Address

Gender

Male
Female

Gaurdian Name

Phone Number

Emergency Contact Name

Phone Number

Dr. in event of Emergency

Phone Number

Convenience Fee

$0.00

Running Total

$0.00

Total

$0.00

Agree*

IMPORTANT!
I agree that I, the registrant will abide by the rules of High Desert Park & Recreation, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with playing a sport, I hereby release, discharge and/or otherwise indemnify the coaches, and associated personnel, including the owners of the fields and facilities utilized for the programs, against any claim by or on behalf of the registrant as a result of the registrant's participation in the programs and/or being transported to or from the same, which transportation I hereby authorize.

Consent for medical treatment*

I hereby give consent for emergency medical care prescribed by a dully licensed Doctor of medicine or Doctor of dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of the registrant.

Check all that apply

Head/ Assistant Coach
Referee

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