Você está na página 1de 1

TUNKHANNOCK TIGERS INDOOR SOCCER LEAGUE

The Tunkhannock Tigers Indoor Soccer League exists for 3 purposes: (1) to advance player development, skills and abilities, (2) to provide an indoor, recreational opportunity during the winter season; and (3) to promote the game of soccer.

What: Where: Who: When:

Cost: Discount: Schedule: Info:

A 9-week indoor soccer league from January 4 March 1, 2014 Tunkhannock Area School District Administration Gym (41 Philadelphia Ave, Tunk.) Any male or female student from Pre-Kindergarten to 8th grade Based on the number of players per grade, an approximate time frame could be: - Pre-K to Kindergarten: 7:50am-10:15am - 1st-2nd grade: 10:15am-12am - 5th-6th grade: 2:00pm-3:30pm - 3rd-4th grade: 12pm-2:00pm - 7th-8th grade: 3:30pm-5:30pm th $50.00 per player in Pre-K to 8 grade $5 discount for each additional player in the immediate family 1 player - $50; 2 players - $95; 3 players - $140, etc. Look for us on Facebook www.facebook.com/tunkhannock/indoor.soccer -(will be posted online over Christmas vacation) You will be contacted by your childs coach the week prior to the January 4th start. Krista Dymond / carat4@epix.net / 570-996-5001 Nolan Robinson / nolan.robinson@tasd.net / 570-833-0164 All registrations must be received

ATTENTION:

by Friday, 11/22/13

at the address listed below. There will be a $10

LATE CHARGE FOR EACH PLAYER if registration and payment is not received by this date. As in the past, we will attempt to
honor all requests; however there will be NO REQUESTING FOR LATE REGISTRATIONS, so sign up early. DUE TO OUR INCREASING NUMBERS, ABSOLUTELY NO REGISTRATIONS will be accepted AFTER 12/13/13. In addition to our profits being used towards scholarships and donations for soccer programs within our community, $5 of EVERY registration will be going to the

Sandy Ide Scholarship Fund!

2014 Tunkhannock Tigers Indoor Soccer League Registration


Please use separate registration forms when registering multiple players. Players first & last name _________________________________________ Parent(s)/Guardian(s) names______________________________________ Address ______________________________________________________ Best phone to reach you at: _______________________ cell or home Grade ___________ Gender _________ Shirt size, 50/50 blend t-shirt (each player will receive a t-shirt) Circle one: Adult Small Youth Small Adult Medium Youth Medium Adult Large Youth Large Adult XL

TUNKHANNOCK TIGERS INDOOR SOCCER LEAGUE 2014 Indoor Soccer Individual Liability Release Form
I the undersigned hereby certify to be a custodial parent or legal guardian of ___________________________________________ (Print Childs Name), and certify that my child is physically fit, mentally capable and medically qualified to participate in the Tunkhannock Tigers Indoor Soccer League (TTISL) program and related activities. I understand that soccer is an active physical sport and that injuries can occur. I understand that every effort will be made to contact me in case of an emergency concerning my child, however, if I cannot be reached and/or if time is of essence, I hereby give my permission to TTISL, its affiliated organizations and sponsors, its/their employees, coaches, referees and league personnel to seek appropriate medical attention for my child, for medical attention to be given and received by my child in the event of accident, illness, or injury during the period of the games. I will be responsible for any and all cost of medical attention and treatment. I, the undersigned, for myself and my heirs, executors and administrators, assume all of the risks and hereby agree to release, absolve, discharge, indemnify and hold harmless to the fullest extent allowable by law, TTISL, its officers, organizers, sponsors, coaches, referees, volunteers, and others appointed by them, as well as any person transporting my child to and from medical care from any and all legal responsibility for injuries or accidents which may occur at any TTISL event, and I further waive and release, and forever discharge TTISL, its affiliated organizations and sponsors, its/their employees, coaches, referees and league personnel, the Tunkhannock Area School District, all School Administrators, Tunkhannock Area Board of Education and/or Administrators and any TTISL volunteers from any and all claims or liabilities in connection with medical treatment, transportation to and from medical treatment and any accidents or injuries which may occur during the course of any TTISL Indoor Soccer matches or related activities conducted in or about the Tunkhannock Area School District Administration Building.

. . . .cut and mail .

The league needs your support. Please indicate if you are willing to: ____ Be the Head Coach of a team ___ Be an Assistant Coach of a team

Name of Child's Insurance Company___________________________ Policy Number_____________________________________________ Policy Holder______________________________________________ Parent or Guardian Signature_________________________________ Parent or Guardian Name (please print) ________________________ Emergency Contact ________________________________________ Emergency Phone Numbers (list all) ___________________________ ________________________________________________________ Date _____________________ List medical concerns/allergies below

Comments (teammate requests due to car pooling, coach requests, etc)

________________________________________ ________________________________________ ________________________________________


- Please make checks payable to: Tunkhannock Tiger Soccer - To be placed on a team, registration must be received by 11/22/13. NO REQUESTS after this date and there will be a $10/player penalty for late registrations. NO REGISTRATIONS accepted after 12/13/13. Complete all information, detach lower portion and mail check payable to: Tunkhannock Tiger Soccer 32 West Harrison Street Tunkhannock, PA 18657