KINTORE OPTIMIST SOCCER REGISTRATION INFO 2017
Team
Peanut
Age
20122013
Day/Time
Wednesday @ 6:30pm
Price
$40.00
Tyke
20102011
Wednesday @ 6:30pm
$40.00
Junior
20082009
20062007
20042005
20022003
Tuesday and Thursday
@ 7pm
Tuesday and Thursday
@ 7pm
Tuesday and Thursday
@ 7pm
Monday @ 7pm
$75.00
Additional Info
Price includes a returnable soccer jersey
•
No travel for this age group, all games
are in Kintore
•
Price includes a returnable soccer jersey
•
No travel for this age group, all games
are in Kintore
•
If a new jersey is required, cost is $20.00
$75.00
•
If a new jersey is required, cost is $20.00
$75.00
•
If a new jersey is required, cost is $20.00
$85.00
•
•
Atom
Intermediate
Senior
•
If a new jersey is required, cost is $20.00
players must include a wallet size photo
with name and date of birth written on
the back and a copy of their birth
certificate for proof of age
Under 17
2000Wednesday @ 7pm
$85.00
•
If a new jersey is required, cost is $20.00
2001
•
players must include a wallet size photo
with name and date of birth written on
the back and a copy of their birth
certificate for proof of age
Under 21
1996Sunday @ 7pm
$90.00
•
If a new jersey is required, cost is $20.00
1999
•
players must include a wallet size photo
with name and date of birth written on
the back and a copy of their birth
certificate for proof of age
•
FILL OUT THE ATTACHED REGISTRATION FORM, SEND WITH POST-DATED CHEQUE (MARCH 1, 2017) MADE
PAYABLE TO KINTORE OPTIMIST AND MAIL OR DROP OFF TO: Whitney Henderson c/o Kintore Optimist
Soccer Program, 842742 Road 84, Thamesford, ON, N0M 2M0
•
TEAM SIZE IS RESTRICTED TO 21 PLAYERS, SO REGISTER EARLY! REGISTRATIONS WILL BE ACCEPTED UNTIL
MARCH 15, 2017. AFTER THIS DATE, LATE REGISTRATIONS ARE ONLY ACCEPTED IF PLAYERS ARE STILL
NEEDED IN THEIR AGE GROUP. A LATE FEE OF $25.00 WILL BE APPLIED.
•
RECEIPTS WILL BE HANDED OUT AT THE FIRST GAME BY THE COACHES
SEASON
•
Regular season begins early May until end of July
•
U21 have playoffs in August
COACHES
•
Coaches are needed for all age groups
•
If no coach comes forward there will NOT be a team for that age group
•
Your participation is required and appreciated!
•
All coaches are required to do an annual police check and attend the coaches clinic (details will be provided in
the spring)
REFEREES & LINESPEOPLE
•
Clinic offered in spring (date to be announced), linespeople and referees can start at age 12
•
This is a good way to complete community hours for high school students
•
For more details please email [email protected]
VOLUNTEER OPPORTUNITIES
•
Looking to help out in your community? There are many opportunities still available on the Kintore Optimist
soccer Committee
•
Positions still available are: Equipment Coordinator, Uniform Coordinator, Referee Coordinator, Food Booth
Coordinator, Team Photos, Tournament Coordinator
•
Please contact us via our Facebook page (Kintore Optimist Soccer) or email [email protected]
KINTORE OPTIMIST SOCCER REGISTRATION FORM 2017
Please print in ink and ensure the information is complete and legible
Player Name: ___________________________________ Birth date(yr/mo/day)________________
Address: _____________________________________________________phone #:_____________
Parent’s Email
(required by coaches and program coordinator): __________________________________________
Are you interested in being a lines person? (must be 12 yrs of age)
Yes _____ No _____
Are you interested in being a referee? (must be 12 yrs of age)
Yes _____ No _____
Names of Parents/Guardians: ________________________________________________________
Signature of Parents/Guardians: ______________________________________________________
Are you interested in coaching? Yes _____ No _____ If Yes, which age group? _________________
Are you interested in helping with the program? Yes _____ No _____
If Yes, please circle a position that interests you:
Equipment Coordinator
Uniform Coordinator
Team Photos
Tournament Coordinator
Is a new shirt required?
Yes _____
No _____
Referee Coordinator
Food Booth Coordinator
Other
If Yes, what size? __________
If you have an existing shirt # and you know what it is please provide ___________
Photo/Video Release Form
I hereby give permission for images of my child, _______________ captured during soccer through participating
in the Kintore Optimist soccer program and the league to be published.
Parents’ signature:_______________________________ Date:_________________
League Policy Waiver
I hereby confirm that my child, __________________ does not play for any other competitive soccer league
during the time which they will be participating in the Kintore Optimist Soccer program and the league to
which we belong.
Parents’ signature:_______________________________ Date:_______________________
(Below filled in by Kintore Optimist)
Shirt Required?
Y or N
Size _____
Shirt # ____ Money Paid $ ________
Chq or Cash
Receipt Issued: __________ Siblings included in this payment:_____________________________
Special Notes: _____________________________________________________________________