GSCYSA Registration

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GSCYSA Soccer Membership Form
Registration Fee $75.00
Child must be 4 years old as of July 31, 2008.

Last Name
First Name
Address
City		State
Zip Code
Phone
DOB
Gender	MaleFemale
Last 4 digits of Childs SS#	(required by KYSA)
Shirt Size	SM(4-6) Med(8-10) Lg(12-14) Adult Sm Adult Med Adult Lg
Did Child Play Last Year?	YesNo
If Yes, Team Name/Coach
Parent’s e-mail address
Fathers Name		Work/Cell #
Mothers Name		Work/Cell #
Parents are REQUIRED to participate/volunteer in the program. (check one)
	Coach Assistant Coach Phone Calls for Team Line Fields Board Position Lay Out Fields (once)
Volunteers fulfilling Board Positions will receive a full refund of registration fees.