Attention:
Lady Pirates Soccer
Players and Parents
I have been in conversation with athletes, coaches, and parents regarding summer soccer for our
team and I’ve have decided to enter our team in the Hogg Creek Soccer League (HCSL), provided I
can get enough commitment from our players and parents. The HCSL has been in operation since
2005 and has over 21 girls’ HS teams from the surrounding area. The benefits of the program are
obvious: gain game experience, skills, fitness, and HCSL hosts a quality one-day camp for all
participants. For more information visit: www.eteamz.com/hoggcreeksoccer/.
Some of the details:
Schedule - There will be 9 games from June 1 through July 15. Games are only on Mondays and
Wednesdays, in the evenings, and they are very local and/or at our home field.
Practices for the team are optional and will depend on coach availability.
Payment - $34.00 per player. Make checks to Joel Steinmetz.
(Cost covers registration for individuals, coaches, and team. It also covers a team
shirt/jersey. Any balance will be returned in the form of popsicles).
Coaching - I will share coaching responsibilities in the HCSL, with a few volunteer-assistants. I will
have to avoid several of the HCSL events to conserve my coaching-days (due to
OHSAA rules regarding the number of coaching days in the summer). Note: I will save my
coaching-days for the last week of July when we will have our pre-season practices.
Attendance –This league is CASUAL and for FUN, so attendance is not mandatory. However, we will
need to know how many players are going to show-up to each contest. For my
planning, please fill out the attached form, so I can figure out how many players I will
likely have each week. I know everyone is very busy in the summer, but if you are in
town please make this a priority!
Divisions - Our team will consist of entering 9th graders to recent graduates.
The Bluffton MS team will consist of entering 6th-8th graders.
Hogg Camp -All participants are invited to attend for free; others may attend for a fee. Last year the
camp was held on the 3rd Saturday of June from 10:30 AM – 6:30 PM in Ft. Jennings.
It will be similar this year.
What I need from each BHS player:
1. US Youth Soccer Player Membership Form (OYSAN)
2. Medical Release Form
3. Player Information Form and Summer Availability Chart
4. Check for $34.00 to Joel Steinmetz. Memo Line: HCSL
DUE DATE: Monday, April 18th.
Please contact me with any questions.
Joel Steinmetz
225 South Lawn Avenue
[email protected]
(H) 419-358-1402
(C) 419-516-2850
US Youth Soccer Player Membership Form
OHIO YOUTH SOCCER ASSOCIATION NORTH
League Name:
Age Group:
Hogg Creek Soccer League
Club/Team Name:
HS
Male/Female:
Female
Player ID #:
Bluffton
First Name: ______________________ M.I.: ______ Last Name:
Address:
City: _____________________
State: _____________ Zip: __________ Area Code/Tel. Number:
Email:
Birth Date: _____________________________
Cell Phone:
Mother’s Month & Day of Birth: _____________ (Required)
Father’s Name:
Mother’s Name:
(First Name; Include Last Name if Different from Player)
Last Club Team Played On:
(First Name; Include Last Name if different from Player)
Primary or Secondary Team: _______________(Required)
(State Cup teams should always be primary)
WAIVER OF LIABILITY:
By checking one of the boxes below, I the parent/guardian for the above child release, discharge and/or otherwise indemnify the
organization/league/club for which I am registering the child to play, US Youth Soccer, the Ohio Youth Soccer Association North, its affiliated
sponsors, employees and associated personnel, including the owners of fields and facilities utilized against any claim by or on behalf of the registrant
as a result of his or her participation.
o
By checking this box, I acknowledge that: I am the parent/guardian of the player authorized to consent on the player’s behalf; I have reviewed
this form and the information it contains and represent that it is accurate; and I have opted to print this form, sign it, and return it by mail, instead of
submitting electronically.
Parent/Guardian Signature: __________________________________________________ Date: ___________________________
ACKNOWLEDGEMENT OF AGE DIFFERENCES:
By checking the box below, I acknowledge that I have been informed that my child will be participating on a team consisting of players that may be
more than two years older or younger than my child. I also acknowledge that the opponents may be more than two years older or younger than my
child. I attest that my child can physically and mentally compete with the other participants in this age range. I acknowledge that I have been
informed of this age range which is larger than normally permitted by OYSAN and willingly enroll my child in this program.
o
By checking this box, I acknowledge that: I am the parent/guardian of the player authorized to consent on the player’s behalf; I have reviewed
this form and the information it contains and represent that it is accurate; and I have opted to print this form, sign it, and return it by mail, instead of
submitting electronically.
Parent/Guardian Signature: __________________________________________________ Date: ___________________________
GENERAL CONSENT FOR MEDICAL TREATMENT:
By checking the box below, I give my consent to have an athletic trainer, coach paramedic, and/or doctor of medicine or dentistry provide medical
assistance and/or treatment. I agree to be financially responsible for the reasonable cost of such assistance and/or treatment. This consent does not
apply to major surgery unless surgery must be performed to treat an emergency condition. Attempts will be made to contact parents of players
participating in the program based on information provided on this form.
o
By checking this box, I acknowledge that: I am the parent/guardian of the player authorized to consent on the player’s behalf; I have reviewed
this form and the information it contains and represent that it is accurate; and I have opted to print this form, sign it, and return it by mail, instead of
submitting electronically
Parent/Guardian Signature: __________________________________________________ Date: ___________________________
Lady Pirates
Contact Information for players, coaches, and parent communication.
Parental contact information may be shared with other parents for planning purposes. Please specify if there is
information included, that should not be shared with other parents.
Name
Grade in 2011-12
9 10 11 12
Home Phone
(
)
-
Cell Phone
(
)
-
Home Address
Birth Date
Month:
Day:
T-Shirt Size
S M L XL XXL
Year:
OK to
share?
Mom’s Name
Mom’s Cell
(
)
-
Y/N
(
)
-
Y/N
Dad’s Name
Dad’s Cell
Parents’ Preferred
E-mail Address
Summer Availability – Please circle
the numbers for the days you will be available.
Monday
Wednesday
June
1
June
6
8
June
13
15
June
20
23
June
27
29
July
4
6
July
11
13
July 17-23
July 24-30
Pre-Season Practices
st
August 1
Regular Practices Begin
Y/N