Roselle Park Soccer Club P.O. Box 252, Roselle Park, NJ 07204 Website: www.roselleparksoccerclub.com / Email: [email protected]

FALL SOCCER 2017: SEPTEMBER to NOVEMBER clinic U6 – co-ed U8 – U10 to U19: Ages 5 to 18 REGISTER ONLINE AT www.roselleparksoccerclub.com or IN-PERSON REGISTRATION: MONDAY June 5 – Sherman school cafeteria, 7pm-8:30pm WEDNESDAY June 14 – Sherman school gym, 7pm-8:30pm

REGISTRATION MAY 29 to JULY 7 -- $25 LATE FEE after July 7th Registration may close sooner if team rosters are filled Parent Name: ______________________________________ Email:_____________________________________________ Address: __________________________________________________________ Cell #: ____________________________

PLAYER NAME: ___________________________________

PLAYER NAME: ___________________________________

DOB ____________________________ Male / Female

DOB ____________________________ Male / Female

School _____________________Grade in Sept_________

School _____________________Grade in Sept_________

Previous coach: ___________________________________

Previous coach: ___________________________________

UNIFORM size: SHIRT: runs true to size YS – YM – YL – AS – AM – AL – AXL – AXXL

UNIFORM size: SHIRT: runs true to size YS – YM – YL – AS – AM – AL – AXL – AXXL

SHORTS:

SHORTS:

runs small - consider ordering one size larger

runs small - consider ordering one size larger

YS – YM – YL – AS – AM – AL – AXL – AXXL

YS – YM – YL – AS – AM – AL – AXL – AXXL

SOCKS: S:12-4 - M:4.5-8.5 - L: 9-12

SOCKS: S:12-4 - M:4.5-8.5 - L: 9-12

REGISTRATION FEES clinic U6: $75 for registration co-ed U8: $75 for registration U10 – U19: $75 for registration*

UNIFORM FEES: clinic U6: NO uniform fee: INCLUDED with registration co-ed U8: NO uniform fee: INCLUDED with registration U10 – U19: $50 for 3-piece uniform (shirt, shorts, socks)

(*U10-U18 does not include uniform)

ALL U10-U19 NEW PLAYERS MUST PURCHASE THE FULL UNIFORM for $50. U10-U19 PLAYERS RETURNING FROM SPRING/FALL, CAN USE SAME UNIFORM or PURCHASE A NEW FULL UNIFORM FOR $50, OR SEPARATE PIECES AS NEEDED (shirt $30 - shorts $25 - socks $10) UNIFORM SIZE IS THE RESPONSIBILITY OF THE PARENTS - TAMAÑO UNIFORME ES EL RESPONSABILIDAD DE LOS PADRES

*All fees are non-refundable

MEDICAL RELEASE Soccer presents certain inherent risks and hazards, which the player-participant and parent/guardian are urged to consider and which the player assumes. To the best of my knowledge, there are no physical or other health related conditions, which will interfere with my child’s participation unless noted below. I, the undersigned parent/guardian for the above named player, understand and acknowledge that such recreational activities have inherent risks, dangers and hazards, foreseeable and unforeseeable, that may result in injury, illness, or property damage, and on behalf of myself, my family, agents and contractors, I hereby release and agree to hold harmless Roselle Park Soccer Club, its sponsors and its coaches, managers, board members and trustees, from all claims actions, or losses related thereto. Roselle Park Soccer Club assumes no liability for injury or damage arising from the results of participation of the above player. ALTA MÉDICAL: Fútbol presenta ciertos riesgos y peligros inherentes, que se insta al jugador - participante y los padres /tutores a considerar y el que el jugador asume. A lo mejor de mi conocimiento, no existen las condiciones físicas o de otro tipo relacionados con la salud, los cuales interferirá con la participación de mi hijo a menos que se indica a continuación .Yo, el padre / tutor para el jugador nombrado anteriormente, entiendo y reconozco que tales recreativo actividades tienen riesgos inherentes y peligros , previsibles e imprevisibles, que pueden resultar en lesiones, enfermedad o daños a la propiedad , y en nombre de mí mismo, de mi familia , agentes y contratistas, por este medio libero y sin responsabilidad a Roselle Park Soccer Club, sus patrocinadores y sus entrenadores , gerentes , miembros del directorio y síndicos, por las reclamaciones, acciones o las pérdidas relacionadas con la misma. Roselle Park Soccer Club asume ninguna responsabilidad por los daños que resulten de los resultados de participación del jugador anterior. CODE OF CONDUCT: I have read, understand and agree to comply with the “RP Soccer Club Code of Conduct” of all players, parents (family and friends) and volunteers. (Can be found online at roselleparksoccerclub.com, under Information. A copy will also be available for reference at in person registration) CÓDIGO DE CONDUCTA He leído, entiendo y acepto cumplir con el "RP Soccer Club Code of Conduct" de todos los jugadores, padres (familia y amigos) y voluntarios. (Puede leer en línea en roselleparksoccerclub.com, bajo Información.Una copia también estará disponible para referencia en el registro in person) MEDIA RELEASE In consideration of my participation in the Roselle Park Soccer Club (RPSC), I hereby authorize the use of any photographs and/or video taken of me, or my child, while participating in any activity with the RPSC. COMUNICADO DE PRENSA En consideración de mi participación en el Roselle Park Soccer Club (RPSC), por la presente autorizo el uso de cualquier tipo de fotografías y/o video tomado de mí, o mi hijo, durante su participación en cualquier actividad con la RPSC. I, the undersigned parent/guardian for the above named player(s), authorize the Roselle Park Soccer Club to create an online account in my name. I understand that all fees (registration and uniform) are NONREFUNDABLE. Yo, el padre / tutor firmante para el jugador nombrado anteriormente, autorizo al Roselle Park Soccer Club para crear una cuenta en línea en mi nombre. Entiendo que todas las tarifas (inscripción y uniforme) son NO REEMBOLSABLES.

Parent/guardian signature: ____________________________________________ Date:___________________ I would like to coach a team (if yes, which age group? )______________________________________________ I am available to set up the field(s) ______________________________________________________________

REGISTRATION WILL CLOSE July 7*, 2017 *Registration may close sooner if team rosters are filled Player Eligibility (U10 – U19) * Travel players are not eligible for ICYSL if their travel card is currently being held by a travel team. If a player discontinues a travel program, they will not be eligible for ICYSL until the following season. ICYSL players cannot participate as ‘guest’ players for a travel or a club team. La elegibilidad del jugador (U10 - U17)* Los jugadores viajan no son elegibles para ICYSL si su tarjeta de viaje actualmente está en manos de un equipo de viaje. Si un jugador interrumpe un programa de viajes, no serán elegibles para ICYSL hasta la temporada siguiente. ICYSL jugadores no pueden participar como jugadores invitados " para un viaje o un equipo de club.

For office use only:

cash

CC

U6: $75 U8-U19: $75

check #________________ SHIRT: $30 LATE FEE: $25

Receipt# __________________________

SHORTS: $25

SOCKS: $10

FULL UNIFORM: $50