Registration Form Player's First Name Player's Last Name Player's Date of Birth ---123456789101112/---12345678910111213141516171819202122232425262728293031/---20182017201620152014201320122011201020092008 Gender ---FemaleMale Jersey Size ---Youth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult Large Division: U6 Summer Program (August) Division: U8 (Based on Birth Year) Division: U10 (Based on Birth Year) Division: U12 (Based on Birth Year) Interested in Competitive Are you interested in your child playing for a South Range Soccer Club Competitive Team? Division: U14/U15 (Based on Birth Year) Interested in Competitive Are you interested in your child playing for a South Range Soccer Club Competitive Team? Allergies or Physical conditions of which the staff should be aware: Parent Name Parent Email Parent Phone Full Address (City, State & Zip) Interested Volunteering? Head CoachAssistant CoachRefereeParent Helper Medical Release Liability Waiver Form I, the parent or guardian for my child (“Participant”) release, discharge and/or otherwise indemnify the organization/league/club for which I am registering the child to play, Ohio Youth Soccer Association North, it’s affiliated sponsors, employees and associated personnel, including the owners of the fields and facilities utilized against any claim by, or on behalf of, the registrant as a result of his or her participation. Consent for Medical Treatment (MINOR) I hereby give my consent to have a coach, athletic trainer; emergency personnel and/or doctor of medicine or dentistry provide my son/daughter with medical assistance and/or treatment and agree to be responsible financially for the reasonable cost of such assistance and/or treatment. Click continue to complete this registration or register another player.