CHARITON RECREATION DEPARTMENT                                                                               

2007 Youth Soccer Registration Form

 

NAME_______________________________GRADE: (In Fall 2007)_____________

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 to City Hall by August 16th.
Any forms returned after the 16th will be assessed a $5 late fee.

(No one will be allowed to participate until registration fees are paid.)
Coaches Draft Meetings are tentatively scheduled for Tuesday,  August 21st at the Chariton City Hall:
                                Pee Wee - 5 pm; Minors - 5:45;  Majors - 6:30

 

 v      Call John @ Chariton Recreation Dept., 774-0670, or email recdirect@iowatelecom.net for more information.