NEWTON YOUTH SOCCER   

www.newtonsoccer.org 

*****  Intramural REGISTRATION Paper Form *****   

REGISTRATION PROCEDURES AND FEES: All registrations are handled on a first come first served basis.  Registration forms must be completed and mailed with the season’s fee; $90 for the first child in a family; $70 for each additional child; (If the fee presents a hardship, please note the hardship on a separate sheet.)   A $15 late fee will be assessed for registrations postmarked after the deadline.  The registration fee covers uniforms, trophies, team equipment, referees and field improvements.  Please make checks payable to Newton Youth Soccer, and please include your phone number on the check.    

TEAM ASSIGNMENTS: NYS attempts to organize teams according to public elementary school district (where the player resides).  With over 1,500 players, NYS cannot accept specific team requests.  Under no circumstances will requests for a specific team or coach placement be considered for any reason and no player will be switched from one team to another after the final team selection.  These rules have been adopted by NYS’s Board of Directors and will be strictly enforced.  Private school students will be placed on a team within their public elementary school district.  Players registering late might not be placed on teams within their school district.  You will be notified of your team assignment by your coach no later than 8 days before the start of the season.   

GAMES AND PRACTICES: Games are scheduled on Saturday afternoon.  Practices are not required but recommended.   Time an place determined by the coach.

UNIFORMS AND EQUIPMENT:  Shirts, shorts and socks are supplied by the League in the Fall.  Shin guards are mandatory.  NYS recommends shin guards with padded ankle protection.  Soccer shoes with molded rubber cleats are recommended for Grades 1 through 6 and are required for Grades 7 through 10.  Metal cleats are not allowed in any grade.   

COACHES: NYS would not exist without volunteer coaches and assistant coaches, and these coaches are you!  Each team must have at least one adult coach and under no circumstances will more than two coaches be assigned to a team.  Coaching is a rewarding experience and parents are encouraged to volunteer.  No previous soccer experience is required in order to join the fun with your children.   

COACHING CLINICS AND ASSISTANCE: Introductory and intermediate coaching clinics, courses and on-going assistance are available.   

BAYS: NYS participates in Boston Area Youth Soccer (BAYS),  a more competitive travel league, separate from this intramural program. BAYS takes place in the Fall and Spring with tryouts in the Fall only.  When applicable, your child is encouraged to play in both the BAYS and Intramural programs.  While NYS will do everything it can to avoid scheduling conflicts, eligible players and coaches participating in BAYS as well as in intramural programs should make a good faith effort, to resolve the scheduling conflicts 50/50 between the programs. THIS FORM IS NOT INTENDED FOR BAYS REGISTRATION. Check our website for a form and ask your spring coach if you're eligible to play BAYS in the Fall.   

CONTACT US:  Website at newtonsoccer.org (email preferred) ; call the soccer line at 244-1650 ; write to N.Y.S., P.O. Box 610308, Newton, MA 02461 

THIS INTRAMURAL APPLICATION WILL NOT BE PROCESSED UNLESS FULLY COMPLETED. 

Please save this top of the form and mail bottom part with applicable fees 

Child’s Name:                                                                          Birthdate (m/d/y):                              Sex:____         

                          First                       Last                         M.I.      

Address:                                                                                   Zip:                   Home Phone:                                

Email (Parents):                                                                  Grade:                                                   School:  ________________________                

Public Elementary School District (if in middle or private school):      _____________________________   

Father’s Name:                          Day Phone:                   Mother’s Name:                        Day Phone: ________

In Case of Emergency:   Person to contact:                                           Phone Number: ____________ 

                                          Doctor to notify:                                                Phone Number: ____________ 

Medical Insurance Carrier:                                                                

How did you hear about NYS program? (circle one):  Mail    Library     Recreation Dept.    School    Other: _______ Parents, without you and other volunteers as coaches, there would be no teams!  PLEASE VOLUNTEER!    

Parent’s name:                                                                (circle one) :         Coach            Assistant Coach    

Coaching Experience  (not required):                                        I would prefer to volunteer with                               

A maximum of two coaches will be assigned per team. 

FINANCIAL CONTRIBUTIONS: In order to continue to offer quality soccer, additional funds are needed to cover rising expenses for new equipment and help maintain new fields.  Please consider a tax deductible contribution to help the League. 

Thank you! 

Contribution:     $20       $30       $____ 

RELEASE 

I, the parent/guardian of the person named on this form, a minor, agree that I and the registrant will abide by the rules of the United States Youth Soccer Association (USYSA), Massachusetts Youth Soccer Association (MYSA), Boston Area Youth Soccer (BAYS), Newton Youth Soccer (NYS), their affiliated organizations and sponsors.  I desire to have the registrant participate in the soccer programs and activities, whether they are indoors, or outside, and including practices and clinics ("Programs"), offered by or in connection with the USYSA, MYSA, BAYS, NYS, and /or their affiliated organizations and sponsors.  I recognize that the registrant may suffer physical injury as a result or the registrant's participation in the Programs.  Accordingly, in consideration for and as an inducement to USYSA, MYSA, BAYS,  and NYS accepting the registrant for participation in the Programs, on behalf of myself and the registrant I, hereby release, discharge, hold harmless and indemnify USYSA, MYSA, BAYS, NYS, their affiliated organizations and sponsors and respective officers, directors, employees, coaches, committees and associated personnel, including, without limitation, the owners of the fields and facilities utilized for the Programs, of and from any claims, demands, actions, causes of action, suits and liability arising as a result of the registrant's participation in the Programs including, without limitation, the transport of the registrant to or from the Programs, which transportation I hereby authorize. 

CONSENT FOR MEDICAL TREATMENT OF A MINOR 

As parent or legal guardian of the minor named on this form I give my consent to seek, obtain, and provide emergency medical treatment for such minor in case of injury that occurs while participating in Newton Youth Soccer‑related activities.  This care may be given under whatever conditions are necessary to preserve life, limb, or well‑being of such minor.  I understand that such treatment will be sought and provided only in an emergency and that reasonable efforts will be made to contact me before providing such treatment.   

Name of Parent/Guardian for Release and Consent (print):   

Signature:                                                                                                                     Date:__________________ 

TO THE PARENT OR GUARDIAN:  You are not required to provide the following information.  This information will be useful if your child requires emergency medical treatment. Please inform your coach of any health or emotional issues.   

Date of last tetanus shot:                                                            Other allergies:_______________________ 

Allergies to medications:                                                    Present medications:________________________   

2010  NYS   

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