CHARITON RECREATION
DEPARTMENT
2011 Youth Soccer Registration Form
NAME_______________________________GRADE: (In Fall 2011)_____________
SHIRT SIZE: (In case we have some donated) ____Youth Small ____Youth Medium
____Youth Large ____Adult Small ____Adult Medium ____Adult Large ____Adult XL
AGE:_____ BIRTH DATE__________ SEX M____ F _____
PHONE (H) _____________ __________ PARENT'S WORK # _____________________
ADDRESS_______________________________CITY_______________ ZIP__________
PARENT'S NAME(S)_______________________________________
EMAIL___________________________________________
PARENTS: Please check one of of the following:
1.____
I will volunteer to coach a youth soccer team.
2.____ I would be an assistant coach.
3.____ I do not want to coach, but I would if you are desperate.
4.____ I cannot coach, but I will help out at games by keeping time or
score.
5.____ I cannot coach or help out.
Return
this page along with the registration fee ($20) to City Hall by August 9th.
Any forms returned after August 9th will be assessed a late fee.
(No
one will be allowed to participate in any games or practices until their entry
form and registration fees are turned in.)
Coaches Draft Meetings are tentatively scheduled for Tuesday, August 16th at the
Chariton City Hall:
Pee Wee - 5 pm; Minors - 5:45; Majors - 6:30