SEMINOLE YOUTH SOCCER
Spring 2017 – Registration Form
Coed – Ages 3 to 18
www.seminoleyouthsoccer.com
Phone: 407-324-5354
Child's Name ________________________________________________________________________________________
Sex ______
Date of Birth
Age as of 9/1/16
________
__________________________
Number of Seasons Played __________
School (If Applicable) ____________________________________
Parent Name(s) _____________________________________________________________________________________
Street Address ____________________________________________ City _______________________ Zip __________
Home Phone # _____________________________
Work Phone # ____________________________
Email Address _____________________________________________
Uniform Size (please circle one):
YXS
YS
YM
YL
(4T-5T)
(6-8)
(10-12)
(14-16)
AS
AM
AL
AXL
If your child played in the Fall 2016 season, do you want to stay with the same group of kids?
List any special requests you may have.
AXXL
Yes
No
_________________________________________________________________
______________________________________________________________________________________________________________________________
Would you like to coach a team? (See discounts below.)
_______ Head Coach
_______ Asst. Coach
Would you like to be a team mom or dad?
_______ Mom
_______ Dad
Fee Calculation
Registration Fee:
New Players:
*Single Child ………..…….$150
*Head Coach's Child.....….$ 70
*Multiple Children ..……...,....…$145 ea.
*Assistant Coach’s Child………...$120
Returning Players from Fall 2016 (no uniform needed)
Single Child ………..…….$125
Multiple Children ..……...,....…$120 ea.
Head Coach's Child.....….$ 50
Assistant Coach’s Child………...$100
*Registration Fee includes a full uniform for children (jersey, shorts and socks).
**If you mail your registration after the January 14th deadline, you must also include the $25 late fee for each child. Faxed and
emailed forms cannot be processed until the registration fee is received.
Fee Calculation:
Number of Children _____ x Registration Fee ______
Number of Late Fees _____ x
$25
Total Amount of Payment
Make Checks Payable and Mail to:
=
____________
=
____________
=
____________
Seminole Youth Soccer
P.O. Box 953934
Lake Mary, FL 32795-3934
------------------------------------------------------------------------------------------------------------------------------------------------------------------
Registration Deadline:
Season Dates:
Refund Policy:
Jan. 14, 2017, must add $25 late fee after this date
Opening practice – 2/25/17 Opening games – 3/11/17
***No refunds after Feb. 25, 2017
***There is a $20 processing fee for any refunds issued before the 2/25/17 deadline
Office: 1325 S. International Parkway
Suite #2211
Lake Mary, FL 32746