COFFMAN FAMILY YMCA Youth Outdoor Soccer 2016

COFFMAN FAMILY YMCA
Youth Outdoor Soccer 2016
Youth Outdoor Soccer 2016
Child’s Name
M
Gender
F
Age
Birth date
Address
City
State
Phone
3
Check the correct age group:
 4-5
 6-7
 Early Bird Fees: Members $34 Program
Parent/Guardian’s Name
Members $68
 Fees after March 15th : Members $44
Program Members $78
Head Coaches receive $10 off registration
until coaching spots are filled.
Cell Phone
Relationship
11th
Years of Exp.
 NEW Parent Meetings: Saturday, April
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This activity has been approved
for advertising throughout the
schools however, it is not
sponsored by Springboro Schools.
 10-12
Phone
Special Request
16th
3-5 year olds at 11:30 AM
6 and up at 11:45 AM
Coaches Meetings: Tuesday April 19th
3-5 year olds at 6:00 PM
6 and up at 7:00 PM
Season Runs: April 25th to June 25th,
Each team will practice one night a
week throughout the season
Practices will begin the week of April
25th
Practices will take place during the
weeknights at either: 5:45, 6:30, or 7:15
Parents will receive an E-mail from
player space by Wednesday April 20th
about team/practice information
Each child must have his/her own pair of
shin guards. Cleats are recommended but
not required
The Y will provide a team shirt for each
player
All schedules will be posted on the
website below after April 22nd
http://playerspace.com
 8-9
Emergency Contact
$10 Late Fee After Saturday, April 19th
 Player Evaluation for 8 and up 6PM April
Zip
(Coaches, Assistant Coaches, and Sponsors special requests are met first.)
Please circle proper T-shirt Size:
1.
2.
3.
YS
YM
YL
AS
AM
AL
I hereby certify that my child is in normal health and capable of safe participation in the youth sports program. I
assume all risk(s) and hazards incidental to the conduct of this program and will provide for transportation to and
from the program. I hereby authorize the YMCA to obtain medical treatment for my child in the event that parent(s)
and the emergency contact cannot be reached.
I support the YMCA youth sports philosophy, which is bases on participation, fun, physical fitness, health and
leadership.
I give permission for my child to be photographed or videotaped for in house use, newspaper, television, or any other
form of media.
Please circle one: Yes or No
Parents/Guardian Signature
Date
E-mail
Attention Parents: Our programs rely on volunteer coaches, assistant coaches, and sponsors. Even if you don’t have experience,
YMCA staff and volunteers can help you get started. I am willing to volunteer or I am interested in receiving info on sponsorship
circle one.
COACH
ASSISTANT COACH
REFEREE
Name_______________________________________________________ Shirt Size
Ages as of April 25th 2016
Age Groups / Game times
3 year olds 9:00-1:00
4-5 year olds 9:00-2:00
6-7 year olds 9:00-2:00
8-9 year olds 9:00-2:00
10-12 year olds 2:00-4:00
SPONSORSHIP
____
_E-mail
COFFMAN FAMILY YMCA
88 Remick Blvd Springboro OH
45066 Phone: 886-9622
Fax: 885-9505
Sports Director: Adam Wilhelm
E-mail: awilhelm@daytonymca.org
COFFMAN YMCA 88 Remick Blvd Springboro OH 45066
Sports Director: Adam Wilhelm • Phone: 886-9622 Fax: 885-9505 • E-mail: awilhelm@daytonymca.org
SPONSOR A TEAM!
Our YMCA now offers 5 levels of team sponsorship ranging from $100 to $1000.
For more information on the different levels please contact Adam Wilhelm
www.ymcaonline.org
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