Form Center

Youth Spring Soccer 2017

2. 

4. Coaches are vital to the success of our program. We are looking for Volunteers who can give 2-3 hours of their time each week.

   1. YES! I am willing to coach!

6. Name

7. Phone

9. Email

10. Shirt Size

12. Child Name*

13. Soccer Co-Ed Age as of March 1*
    -- Select One --U6 (Ages 5-6)U8 (Ages 7-8)U10 (Ages 9-10)U12 (Ages 11-12)U14 (ages 13-14)

14. Shirt Size*
    -- Select One --6/810/1214/16ASAMALAXL

16. Age*

17. DOB*

18. Gender*

19. School Attending:*

21. Parent/Guardian Name:*

22. Date of Birth:*

24. Parent/Guardian Name

25. Date of Birth

27. Phone: Home*

28. Phone: Cell

29. Email Address*

31. Address*

33. City*

34. State*

35. ZIP*

37. Are accommodations due to a disability needed to participate?*

    1. Yes
    2. No

39. If yes, please explain:

41. Branson Parks and Recreation will attempt to accommodate ONE request only:
    <center>(We cannot guarantee that coach, ride, and practice request will be granted.)</center>

    (We cannot guarantee that coach, ride, and practice request will be granted.)

43. Coach Request:

44. Ride Request

45. Practice Conflict
    -- Select One --MondayTuesdayWednesdayThursdayFriday

47. By submitting this form you agree:*

    I am the parent/Legal guardian of the above named minor. I hereby waive, release, and forever discharge all claims against the City of Branson, its employees, volunteers, commissioners or agents for damages and/or injuries which may arise from participation in the above named athletic program.
    I hereby authorize any duly licensed physician, emergency medical technician or medical facility to treat the above named minor for injuries that may be received while participating in the above named athletic program.
    I have received, read and understand the Youth Sports Code of Ethics. I hereby agree that if I fail to conform my conduct to the Youth Sports Code of Conduct I will be subject to disciplinary action.

    1. Agree
Leave This Blank:


48. 1. Receive an email copy of this form.
49. Email address

    This field is not part of the form submission.

50. Submit

* indicates a required field