2021 Fall Soccer Registration
Thank you for taking the time to register your child for fall soccer. Our season begins after Labor Day. Practices are on Tuesdays at 6:00 p.m. and games/scrimmages are on Saturdays between 12-3 p.m. Game/Scrimmage start times will vary. Our home field is located at Loch Raven High School.
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Player's Age by August 1, 2021 *
Player's Uniform Size *
Gender *
Player's Full Name *
Parent's Name(s) *
Cell Phone *
Alternate Phone *
E-mail Address for League Communication *
Please describe any allergies or health concerns that the above-mentioned player might have. If none, please write "none." *
Mailing Address *
City *
State *
Zip Code *
Health Insurance Provider *
How Can You Support the League? *
Season Program Comment ($10 Additional Fee)
Payment Status
Liability Waiver & Consent Agreement
I give permission for my child to take part in the Christian Youth Athletics (CYA) Soccer Season. In the event of an injury or medical emergency, I hereby authorize Christian Youth Athletics volunteers to administer First Aid, call 911, and/or take the above-named child to a physician, for emergency room treatment at the nearest available hospital. I acknowledge the risk of physical injury to my child or possibility of my child acquiring a communicable illness, such as COVID-19, flu, or other common childhood ailments by participating in any and all activities at Christian Youth Athletics, or wherever they may take place. I accept personal financial responsibility for any illness, bodily or personal injury sustained or associated with any and all activities at/or sponsored by Christian Youth Athletics. I consent to temperature checks for my registered player and family members who will be attending practices, games, and league activities. I agree to keep my child home if he/she feels ill or displays symptoms of illness. In the event that my child or a member of my household is ill, I will communicate this to the league and take necessary safety precautions to keep other players and families free from illness. I accept full responsibility for damages to equipment and uniforms while in my child’s possession. If damages do occur, I will pay the cost to replace the damaged item(s). I release Christian Youth Athletics, Rock City Church, and all Christian Youth Athletics Member Churches & League Partners from liability for illnesses, accidents, or injury that may occur to my child or family members attending CYA sponsored practices, games, and events. I understand that CYA does not offer refunds for any reason. understand that I am fully responsible for any legal or court fees should I ever decide to take legal action against the league or its member affiliates. I understand that my child’s photograph may appear in CYA media releases, web, or print publications of the league or its’ sponsors. I have read the above statements and hereby give my written consent.
Liability Statement Acknowledgement Signature- By typing my full name below, I agree to the liability statement above and give consent for the player listed above to participate in the 2021 Christian Youth Athletics Fall Soccer Season *
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