Youth Sports — Spring 2013
YMCA of Austin — Southwest Branch
Registration Fees:
Early:$35M/$85NON
Regular:$55M/$105N
Jersey Fee: $10
Financial Assistance “YMCA
of Austin programs and
activities are designed to
benefit persons of all backgrounds, and fees are based
on the cost of providing each
program. While participants
are expected to pay their fair
share, when financial assistance dollars are available,
the YMCA will assist any
individual or family that wants
to participate but cannot afford
the fee.”
Southwest Branch YMCA
6912 OakClaire Dr.
Phone: 512 891-9622
Fax: 512 892-1557
Email: [email protected]
Please check off
Sport and Division
Youth Soccer (co-ed)
Ages:
4-12 years old (divisions listed below)
Registration Dates:
Early: January 7 – February 3
Regular: February 4 – March 3
*Or until Roster spots are filled*
**Registrations will only be accepted after the registration deadline, if
open spots remain, with the approval of a YMCA Director.
Season Dates:
March 23 – May 18 (no games on 3/30)
Helpful Information
Confirmations and league info will be E-MAILED to parents after
registration closes. *Please contact the youth sports department if you
do not receive an email before March 15th.
Games played Saturdays at the branch or surrounding facilities.
All Y Youth Sports teams are supported and coached by volunteers.
Youth Sports Registration Form
Current YMCA of Austin member? Y
Child’s Name
N Member #
Gender M F
Parent Name
Spring Soccer
□ 4-5 yrs. old (Coed)
□
6-7 yr. old (Coed)
□ 8-9 yrs. old (Coed)
□
10-12 yr. old (Coed)
Age at 3/24/13
Primary#
E-mail (please print legibly)_
Child’s jersey size (Check one): $10 Fee
*The YMCA of Austin will be using the green/silver reversible jersey used during the 2012 season.
Youth XXS □
Youth Large □
Youth XS □
Youth S □
Adult Small □
Youth M□
Adult Medium □
Not needed (already have one) □
Child’s Previous Soccer Experience (Circle):
None
Mail or return form and fee to:
Southwest Branch YMCA
6912 OakClaire Dr.
Austin, TX 78735
Phone: 512 891-9622
Fax: 512 892-1557
Some
Moderate
Good
Experienced
I would like to volunteer to coach (name)
If volunteering, what is your shirt size:
S
M
I would like my child to be coached by (name)_
I would like my child and (friend’s name)
to be on the same team
L
XL
2XL
Youth Sports — Spring 2013
YMCA of Austin —Southwest Branch
Youth Soccer (co-ed)
YMCA Youth Sports
Pledge
I pledge to play the game,
The best that I can,
To be a team player,
To respect my opponents,
The rules and officials,
And to improve myself in
Spirit, mind and body.
The mission of the YMCA of
Austin is to put Christian
Principles into practice
through programs that
build a healthy spirit, mind
and body for all.
Additional Information
Kinder Soccer (ages 4-5) will practice 20 minutes before
each game.
Youth Soccer (ages 6-12) will practice once a week. Time
and location will be determined after the coach’s meeting.
Each child is required to have their own practice soccer ball, shin
guards and cleats. Youth Soccer Ball Sizes: ages 4-5 (size 3),
ages 6-12 (size 4).
All Coach’s are required to fill out a Volunteer Application Form
and attend the coach’s meeting before they can coach any youth
team.
We cannot guarantee placement on a specific team or with a
specific coach. No refunds will be given after registration closes
without a medical statement from a physician.
Practices will begin the week of March 18, 2013.
Financial Assistance
“YMCA of Austin programs
and activities are designed
to benefit persons of all backgrounds, and fees are based
on the cost of providing each
program. While participants
are expected to pay their fair
share, when financial assistance dollars are available,
the YMCA will assist any individual or family that wants
to participate but cannot
afford the fee.”
Office Use Only
Membership #
Receipt #
Date Entered
Staff Name_
Mail or return form and fee to:
Southwest Branch YMCA
6912 OakClaire Dr.
Austin, TX 78735
Phone: 512 891-9622
Fax: 512 892-1557
Youth Sports Payment Form
CREDIT/DEBIT CARD (Circle one): Visa
Card #
Mastercard
Expiration Date
Amex Discover
_/
Signature
Refunds are available upon request 10 business days prior to the beginning of
the season. A YMCA System Credit is available on all other cancellations.
THE YMCA DOES NOT PROVIDE ACCIDENT/MEDICAL INSURANCE FOR PROGRAM PARTICIPANTS.
*THE FOLLOWING RELEASE FORM MUST BE SIGNED IN ORDER TO PARTICIPATE.
I grant the YMCA or its agents permission to transport my child in the event of an emergency
when I am unable to be contacted. I recognize that participation in the YMCA activities may
expose my child to some risk of injury. I agree to hold the YMCA harmless from any claims for
damage to any property or injury to persons which may occur through participation in any
activity at the YMCA or in its pro- grams at an outside facility. I also authorize the use of any
photographic image of my child, named herein, taken during Y Youth Sports, for use in any
YMCA publica- tion. I further agree to abide by all YMCA of Austin procedures and policies. I
have read and understand the above information. My child has permission to participate in
this YMCA Youth Sports program with the conditions set forth.
Parent/Guardian Signature
Date