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Kentucky Indoor Soccer and Sports Registration Form
Goal Getters Registration Winter 2
Per team fee is $450. Individual fee is $60
All team fees MUST BE PAID in full prior to the first game. Winter 2 session starts Sat Jan. 14th
Deadline to put in a team/individual will be Jan. 2nd (unless we fill before the deadline)
Teams must pay a deposit of $100 to secure a spot and that amount will then be deducted from the total cost of the team.
NO REFUNDS AFTER THE REGISTRATION DEADLINE HAS PASSED
I am registering a
Individual ($60) · Schedules are posted on our website and it is necessary that
Includes Tshirt each team have at least one player with website capabilities.
Team ($450)
Place a checkmark next to the league you want to join:
Under 5
Are you interested in
coaching?
Under 6
Yes
No
All Games are on Sat mornings, Max 8 players per team. Each team plays with 4 players on the turf, no
goalkeepers. Games consist of 4-9 min qtrs. Games are conducted by team coaches. Team t shirts provided
Team Name:
If registering your child as as individual please leave the team name blank and fill out the info below. Players
registering as individuals will be placed on teams. We will form pure U5&6 leagues if possible but we reserve
the right to combine leagues if necssary. Teams must fill out rosters which are available at kyindoor.com
Contact Information
Parent/Contact's Name
Email Address
Child's Name
Street Address
City
State
Home Phone
Zip
T Shirt Size
Work Phone
Cell Phone:
Credit Card Payment: We accept Visa, MC and Discover
Card Type
Card Number
Name On Card
Expiration Date
Amount to Charge $
Please read the important information below:
· A team roster is due prior to the first game. It may be changed until the end of the third game at which point the roster is frozen. Teams that play with a non-registered player risk
forfeiture of that match, but ONLY if the opponent protests the game at the time it is playing. We do not check rosters prior to each match. If a roster check is requested and the team
in question has not submitted one, an automatic forfeit will be given. Each roster form has a disclaimer. This must be provided to all team members by the team contact. The team
contact is responsible for and must collect the entire team fee.
Waiver/Exclusion Clause (please read carefully)
I, the parent/guardian/participant, in registering at Kentucky Indoor Soccer & Sports, understand that he/she/I in attending the soccer program and using the facilities does
so at his/her/my own risk. Kentucky Indoor Soccer & Sports, and its owners, employees and agents, shall not be liable for any damages whatsoever arising from any personal
injury or property loss sustained by participant and his/her/my family in or about any programs on the premises. I acknowledge that I am aware of the risks inherent in
participating in indoor soccer (both practice and competition); that indoor soccer is a physical sport which can require considerable running, starting, stopping and physical
exertion; and could potentially lead to limb injuries; possible permanent disability and death. Participants and parents assume full responsibility for all injuries and damages
which may occur in or about any programs on the premises and he/she/I do or does hereby fully and forever release, discharge and hold harmless Kentucky Indoor Soccer &
Sports, all associated facilities and its owners, employees and agents from any and all claims, demands, damages, rights of action, present or future resulting from or arising
out of any person's participation in any programs or use of its facilities. In addition, he/she/I agree(s) to the following rules of play and conduct set by Kentucky Indoor
Soccer & Sports. He/she/I understand(s) that failure to do so may result in suspension from participation.
"As the Team Contact I have read this and agree
to disclose the above information to my team"
"As the parent of the above child I have read the
Waiver/Disclaimer and agree to the terms"
© 2005 Kentucky Indoor. All rights reserved.
Signature:
Team Contact or
Parent's Name
Kentucky Indoor -Lexington
404 Sporting Court Lexington, KY 40503 Ph. (859) 219-1499
Fax. (859) 219-1277