YMCA – Brad Akins Branch
2017 Spring Soccer Timeline

Jan. 9– Feb. 6
Youth Soccer Registration

Feb. 7 – 10
Late Registration (if available) $65 members/$95 nonmembers

Feb. 14
Little Kickers/U6/U8 Coaches Meeting @ 6:30 pm

Feb.16
U10/U12/15U Coaches meeting @ 6:30 pm

Feb. 21
Little Kickers, U6, & U8 Parent orientation @ 6:30 pm
(All parents with children in Little Kickers, U6, & U8 age groups need
to attend)

Feb. 23
U10, U12, and U15 Parent orientation @ 6:30 pm
(All parents with children in U10, U12, and 15U age groups need to
attend)

Feb.27
Soccer practices begin. Mon, Tue, & Thurs practices @ 6 & 7 pm
(Coaches schedule practice time & date)

Week of March 20th Soccer games begin
(Coaches will have schedules)
U6 games played Fridays @ 6 pm or Saturday morning
U8 games played Thursdays @ 6 and 7 pm
U10 games played Fridays @ 6-7 pm or Saturday morning
U12 and 15U games played Fridays and Saturdays (possible away
games)

TBA
Soccer Picture Day @ YMCA
(Coaches will schedule their team’s picture time)

April 17 - 21
Barrow County Spring Break
(No games or practices this week)
Office Use Only
Paid Amount $
_____________
Brad Akins YMCA
2017 Spring Soccer Registration
Date Received
_____________
*PLEASE WRITE LEGIBLY*
(Circle one)
Name
First
Last
Male
Female
Address
City
Zip
Phone
Birth Date
/
/
Age
E-Mail Address
Additional Player Information
Number of
Seasons Played
Other Children in
League
Last Team
Last League and Date Played
Name
Age
Any Physical Problems We Should Know About?
Shirt
Uniform Size
(Circle One)
Registration
Fee:
YXS
AXL
YS
YM
YL
AS
AM
AL
Please Mark Correct Fee:
 Member $55.00
 Non-Member $85.00
SELECT correct AGE GROUP by child’s age as of August 1st, 2016
□ Under-12 (1-1-2005 to 12-31-2006) □ 15 and Under (1-1-2002 to 12-31-2004)
Ages 10-11
Under -10 (1-1-2007 to 12-31-2008)
Ages 8-9
Under -6 (1-1-2011 to 12-31-2012)
Ages 4-5
Ages 12, 13, and 14
Under-8 (1-1-2009 to 12-31-2010)
Ages 6-7
Little Kickers $45 Member & $75 Non Member
(1-1-2013 to 12–31–2013) 3 year olds
Father’s
Name
Mother’s
Name
Cell Phone:
Bus. Phone:
Cell Phone:
Bus. Phone:
Volunteer Opportunities (Circle One)
COACH
ASSISTANT COACH
TEAM MOM / DAD
PHONE CALLS
FIRST AID KIT
*The YMCA Does Not Guarantee any Practice Time Request or Coaches
Request! NO Refunds Will Be Given After Uniforms Have Been Ordered!*
PARTICIPANT WAIVER
As a participant in programs offered through the Winder-Barrow Brad Akins YMCA for either
myself or my child, the undersigned acknowledges and agrees to the following:
1.
The YMCA is a Christian organization and that my child and I are expected to
conduct ourselves in accordance with the teachings of Jesus Christ.
2.
I give my permission to the Winder-Barrow Brad Akins YMCA for the use of photos
and slides that may be taken of my child or of myself and to use, without limitation or obligation,
photographs, film footage, or tape recordings which may include either my image or voice or the
image and voice of my child for purposes of promoting or interpreting YMCA programs.
3.
I understand the Winder-Barrow Brad Akins YMCA assumes no responsibility for
injuries or illness which I or my child may sustain as a result of physical condition or resulting
from participation in any athletic activities, sports programs, the use of any equipment,
exercises, or other activities while on the property of or in conjunction with any activity held,
coordinated or sponsored by the Winder-Barrow Brad Akins YMCA. In consideration of the
privilege of participation at the YMCA, I hereby voluntarily release and discharge the WinderBarrow Brad Akins YMCA, its officers, directors, employees, agents, and/or servants from any
claims whatsoever, including for injury, illness, death, loss or damage which I or my child may
suffer as a result of my/his/her participation in these activities. I understand that no accident or
medical insurance is provided with these activities. I fully indemnify and hold harmless the
Winder-Barrow Brad Akins YMCA, its officers, directors and employees from any and all claims.
4.
I understand the Winder-Barrow Brad Akins YMCA is not responsible for personal
property lost or stolen while members and/or program participants are using YMCA facilities,
participating in YMCA activities, or on YMCA premises.
5.
While the Winder-Barrow Brad Akins YMCA will make every attempt to provide
reasonable accommodations for mentally and physically challenged children and adults, the
YMCA will not accept children or adults that are (a) of danger to themselves, (b) of danger to
others, or (c) a disruption to the normal activities making it unreasonably difficult for other
children or adults to enjoy YMCA programs and activities. Any of the above reasons will be
grounds for dismissal from YMCA programs and activities. We strongly recommend that you
discuss with Winder-Barrow Brad Akins YMCA staff any special conditions or circumstances
involving your child or an adult member in your household. We request that you do this PRIOR to
registration so that we can advise you as to whether we can make a reasonable accommodation
for your child or adult household member.
ACCEPTANCE
I have read and voluntarily signed this waiver and release of liability and indemnification
agreement, and further agree that no oral representation, statements or inducements apart
from the foregoing written agreement have been made. I also accept the Conditions of
Membership as well as the conditions imposed upon participants, both youth and adult, in
activities and programs provided by the Winder-Barrow Brad Akins YMCA.
___________________________________
___________________________________
_________________________
Signature of Member/Participant
Signature of Parent/Guardian
Date