2019 Indoor Soccer
This form must be accompanied by payment ON THE SUPERIOR YMCA SYSTEM. Payment can occur online or in person with Superior YMCA receiving desk staff. Without payment, your child cannot be placed on a roster. This program and all other Superior YMCA sports programs qualifies for financial assistance. Please email Michelle Starry, Membership Director, for more details.
LAST NAME *
Your answer
FIRST NAME *
Your answer
CURRENT GRADE IN SCHOOL *
School Attending during the 2018-19 school year? *
Your answer
Parent(s) Name(s) *
Your answer
EMAIL ADDRESS *
Your answer
MAILING ADDRESS *
Your answer
PHONE NUMBER *
Your answer
CHILD'S t-shirt size *
Each team needs parent-coaches for the station-based practices and for games at the Y. Can you help out your child's team? *
IF you will coach, what shirt size?
THIS IS YOUR DIGITAL SIGNATURE. PLEASE READ THE FOLLOWING BEFORE ANSWERING. I hereby give my permission and approval for the above-named child to participate in all INDOOR SOCCER activities during the 2019 season. I assume all risks and hazards incidental to such participation, and I release the YMCA, supervisors, and coaches from any claim arising from an incident or injury to my child. I also understand that the my child's photo might be used for future promotional efforts and if I object, I must communicate via email or in writing with Jon Reimer, the YMCA's Activities Director. *
Required
How do you intend to pay for the program? *
Submit
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