ROWVA Youth Committee Sports
ROWVA YOUTH COMMITTEE/KCAP/YMCA
FALL 2010 Soccer
Grades Pre-K, K - 1st, 2nd - 3rd & 4th - 5th
Registration Deadline: Thursday, August 5, 2010.
Participation Fee: $25
Late registrations will be charged an additional $5 before the child is allowed to play.
6 game schedule beginning Saturday, September 11, 2010 (weather permitting)
Sign-up will be in the LMC in Oneida on School Registration Day
Thursday, July 29, 2010
Please return registration form and $25 fee payable to RYC at the RYC Sign Up.
or mail registration to: Knox County Area Project, 109 S. Cherry St., Galesburg, IL 61401
(Extra forms are available in the schools’ offices)
One red and one navy all sport shirts must be purchased at the YMCA ($5.00/shirt)
Shin Guards Are Required.
COACHES ARE NEEDED AT ALL LEVELS
There will only be as many teams as there are coaches.
Please contact Laura Woodside at 309-483-6820 if you are interested in coaching.
• The Pre-K and K - 1st teams will be limited to 11 players.
• The 2nd - 3rd and 4th - 5th teams will be limited to 15 players.
YMCA Coaches Meeting: Thursday, August 19, 2010 at 5:30 p.m. at the YMCA in Galesburg.
If you have any questions please call KCAP at 343-4127 or attend the registration on July 29, 2010.
The YMCA and KCAP are United Way Agencies.
--------------------- Cut and return bottom of form with fees -----------------
Participants Name ________________________________________ Age __________ Grade _____________
Parent/Legal Guardian_______________________________________
E-mail _______________________________________
Address ________________________________________________ City ______________________ Zip Code _________
Home Phone _______________________________
Work Phone ___________________________
Cell _______________________
Emergency Contact_______________________________________ Relationship to Participant ________________________
Emergency Contact Phone___________________________________
My child _____________________________________________________ has permission to participate in the ROWVA Youth Committee/KCAP/YMCA Spring Soccer Program. I understand that I am responsible for payments of any medical expenses, which may be incurred from any injury to my child from participation in this activity. I agree that the RYC or any of its coaches will not be held responsible for any injuries or claims for damages of any kind arising from this activity. Also, I agree to release, and discharge the RYC, KCAP, and YMCA from any liability, and covenant not to sue for any and all loss or damage, personal injury, property damage, or wrongful death, whether caused by any negligence, either active or passive of the YMCA, or otherwise. Participation in this activity will be considered as an agreement of this disclaimer by those participating or their parent/guardian.
______________________________________________ ___________________________________ _________________
(Signature) (Relationship to Participant) (Date)
Interested in coaching your child’s team? [ ] Yes [ ] No Will help Coach ? [ ] Yes [ ] No
Payment amount ____________check # _______________ cash ______________
date received ___________