Jan. 2nd through Fe

Registration will be accepted Jan. 2^nd through Feb. 3^rd or until teams are filled. Payment is required at time of registration.

REFUND POLICY: A refund can be requested up to two weeks from the start date of league practice. The refund will be 75% of the registration fee. NO refunds will be made after the two week period.

LATE FEE POLICY: There will be a $10.00 late fee applied for anyone registering after the deadline.

I AM REGISTERING FOR THE FOLLOWING DIVISION:

___ Division A: Currently in K or 1^st Grade

___ Division B: Currently in 2^nd or 3^rd Grade

___ Division C: Currently in 4^th or 5^th Grade

___ Division D: Currently in 6^th, 7^th, or 8^th Grade

Fees: A & B $55 / C & D $60 (includes T-Shirt and Trophy)

PLEASE PRINT ALL INFORMATION

Name of player_____________________________________________________________ Male _____ Female _____

Address ________________________________________________________________________________________

City ____________________ State _______ Zip Code __________ Age ______ DOB _______/_______/___________

School ____________________________________________________________ Grade Level __________________

Parent(s) Name ________________________________________ E-Mail____________________________________

Home Phone ____________________ Cell Phone _______________________ Work Phone _____________________

Did your child play soccer for North Kansas City in 2016? Yes____ No ____ Which Team _______________________

Shirt Size: YXS (6-8) ____ YS (8-10) ____ YM (10-12) ____ YL (14-16) ____ AS ____ AM ____ AL ____ AXL____

Does participant have any medical conditions that may need special accommodation/attention? Yes ____ No ____

Special accommodation request: ____________________________________________________________________

Children may register with one “buddy” for youth team programs. BOTH registration forms must be received along with the registration fee for each child at the same time. If you are new to the NKC Soccer League, you will be placed on a team by the NKC Parks & Recreation staff.

Buddy Name (If Applicable): ________________________________________________________________________

Other Comments: ________________________________________________________________________________

Volunteer Coaches Needed!

Volunteer coaches work with teams under the direction of North Kansas City Parks and Recreation Department.

Let us know if you are interested!

Yes____ No____ Head Coach____ Asst. Coach____

By signing the Registration Form, I acknowledge all risks of injury, illness, death, and property damage, and affirm that I have assumed all responsibility of injury, illness, or death in any way connected with participation in the program. I also agree for myself and for any child participant to follow all rules and procedures of the program and to follow the reasonable instructions of the teachers and supervisors of the program.
Parent of Guardian Signature ________________________________________________ Date __________________

For Office Use Only: Fee Paid _________________ Type _____________ Team _____________

North Kansas City Parks and Recreation

Spring Youth Soccer Registration Form 2017

2251 Howell, North Kansas City, MO 64116 / 816-300-0545 / www.nkc.org