Avery County Youth Soccer 2106 (FALL) Registration Form:
Registration Fee is $50. This includes: Jersey, Socks, Insurance, Referees, and Field maintenance.
Registration after August 24th will require a $10 late registration fee.
Childs Name: ________________________________Date of Birth:_____________________________
Age:___________________
Gender: [ ] Male [ ] Female
School:______________________________________________________________________________
Parent/Guardian Contact:_______________________________________________________________
Address:_____________________________________________________________________________
Home Number:_________________________________Cell Number:____________________________
Email Address:____________________________________________
Jersey Size (please check the appropriate box)
[ ] youth small [ ] youth medium [ ] youth large [ ] adult small [ ] adult medium [ ] adult large
Number of Years Played: __________________Who was your last coach:__________________________
Requests (only 1 request will be honored):__________________________________________________
Parents:
Would you be willing to coach?
YES/NO
Assistant Coach:
YES/NO
*We will have a mandatory coaches meeting on August 31, 2016 @ the YMCA*
Name of person willing to coach:________________________________________________
Number of person willing to coach:______________________________________________
Please Read and Sign:
WAIVER OF LIABILITY: I fully assume and understand the risks of my child participating in Avery County Youth Soccer including
obstructions, sudden illness, death or injury, and all other risks. I attest that my child is physically fit to participate. I authorize program
staff to provide medical attention at my expense should my child appear in need. For injuries my child sustains, including death, I agree
to save and hold harmless the YMCA of Avery County, Avery County Youth Soccer, NCYSA, Avery County, Crossnore School Inc.
volunteers, coaches, program staff, suppliers, contractors and anyone else connected with the organization of this program, from any
claim or lawsuit that may be brought at any time be me, my family, estate, heirs or assigns, arising from my child’s participation in this
program or the instruction received.
WAIVER FOR PUBLICITY: I agree that images taken of my child during this program may be used in any legal manner without payment to
me. I have read and understand the terms of this document. I make this agreement and pay the program fee in exchange for the privilege
of my child participating under the conditions of the program.
Parent/Guardian Signature: __________________________________Date:___________________
Office Use Only
Receipting Clerk: _________________________________________________Date:_______________
CODE OF CONDUCT
Total Amount Paid: _______________________________________________Staff
Initials: ________
PLAYERS: In competition, someone always loses. If you win, do it gracefully, not boastfully. If you lose,
do not be negative. Players are to treat other players, coaches, referees, and spectators in a respectful
manner before, during, and after a match. Players are expected to exhibit good sportsmanship at all
times. Players are to give their team and their coach their best at practices and games. Any player found
climbing, swinging, or defacing any goal, fence, sign, equipment, or property will be subject to
suspension. Players are to wear the appropriate equipment to ensure safe and healthy play. Enjoy
participating in the sport and HONOR the game!
Coaches: Coaches set the example by which players and parent must follow. Coaches are expected to
exhibit good sportsmanship at all times. Disagreements with parents, another coach, referees, or board
members do not belong on the public soccer field. Coaches are expected to treat all players in a fair and
equal manner regardless of talent or ability. Coaches will teach players the rules and fundamentals of
the sport in a positive and encouraging manner. Coaches are to enjoy participating in the sport and
HONOR the game.
PARENTS AND SPECTATORS: Parents and Spectators are to exhibit good sportsmanship at all times and
provide encouragement to players, coaches, and referees of both teams. Disagreements with players,
coaches, or referees do not belong on the public soccer field. Parent’s should offer support and help to
the coaches. Parents should not be on the team’s side of the field or behind the goals. Allow your child
to be a child. Too much competition, too soon, can slow down the progress in skill development. Enjoy
the game and opportunity to be with your child and HONOR the game.
REFEREES AND BOARD MEMBERS ARE EMPOWERED TO REQUEST PLAYERS, COACHES, PARENTS, AND
SPECTATORS TO LEAVE THE FIELD IF THIS CODE OF CONDUCT IS NOT FOLLOWED.