U-14 ENSA (Eastern Nebraska Soccer Association) Spring 2014 REGISTRATION FORM NEBRASKA CITY YOUTH SOCCER CLUB

DEADLINE: February 28, 2014 PLEASE READ THE REVERSE SIDE OF THIS FORM PRIOR TO COMPLETION.
FOR OFFICE USE ONLY PD______ Check #______ U_______ M/F__________

CHILDS NAME: __________________________________ MALE/FEMALE: ______

AGE on July 31, 2013:_______ BIRTHDATE: ____ /____ /_____

MAILING ADDRESS: ______________________________________________________

PARENTS NAME (PRINT):_________________________________ PHONE #__________________ MOTHERS BIRTH DATE E-MAIL: __________________________________ _____ /_____ / xxxx
Month Date Year

(required for state association identification) ARE YOU INTERESTED IN ASSISTING? Coach_____ Manager______

WAIVER: I grant permission for my child to participate in the NCYSC. I release from liability and health responsibility any coaches, directors, and those affiliated as sponsors.
________________________________________ Parent/Guardian Signature __________________ Date

RETURN: ____ FEE $45

_____ Late Fee $5 if after February 28th Please make checks payable to: NC YOUTH SOCCER CLUB ____ BIRTH CERTIFICATE (if not previously submitted) ____ SIGNED FORM TO: Thurmans Bike and Sport, or mail to Sena Hayes, 720 3 Ave., Nebraska City, NE 68410. NOTE: W E CAN NOT PROCESS YOUR REGISTRATION UNTIL ALL REQUIRED ITEMS SUBMITTED.
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FOR REGISTRATION QUESTIONS, PLEASE CALL 873-8848

NEBRASKA CITY YOUTH SOCCER CLUB

The NCYSC encourages fun and good sportsmanship. Using these fundamentals, all players are winners!

The NCYSC is a non-profit volunteer organization. We are a member of the Nebraska State Soccer Association (an affiliate of the United States Soccer Federation) and all players are registered with the NSSA. U-14: Teams participate in the Eastern Nebraska Soccer Association (ENSA) recreation league. Half of the games will be scheduled in Nebraska City and the other half requires travel to surrounding communities. The fall season is scheduled to begin August 24th, however specific game dates are not yet set.
TO REGISTER:

1) Complete the registration form on the opposite side. This form is for U-14 teams only (players ages 12 & 13). Please complete a separate form for each player. 2) Attach a copy of the players birth certificate if this is the first time registering with NCYSC. 3) Enclose reg. fee of $45 payable to NC Youth Soccer Club ($75 for both fall & spring seasons). Add $5 late fee if after registration deadline. (Discount available for 3rd child or for financial need - call 873-8848). 4) Sign and date permission/waiver statement. 5) Return form, fee, and birth certificate if required to Thurmans Bike and Sport or mail to Sena Hayes, 720 3rd Ave., Nebraska City, NE 68410. FOR REGISTRATION QUESTIONS, PLEASE CALL 873-8848. Playing up: The NCYSC generally discourages playing above the players age level but recognizes there are particular circumstances when playing up may be appropriate. Players within one year of the next division (age 11) may be allowed to play up upon the written request of their parent/guardian explaining their individual circumstance.
PLAYERS EQUIPMENT:

Team jerseys are available at Thurmans Bike and Sport. Shinguards covered with socks are also required. Inquiries and comments regarding the NCYSC may be directed to Steve Baltensperger, club president, 873-4521 or ncyscsoccer@gmail.com.

CONTACT NCYSC: