LISBON - The Lisbon Recreation Department has announced signups for its Fall Soccer program for ages 4-12. Registration will be held tonight (Thursday August 2nd) from 5:30 p.m. to 7 p.m. at the Town Recreation building (located behind the ICF).

The program offers four divisions: Little Kickers (4-5 year olds in house program $7 registration fee), Farm League (6-7 year olds in house program $10 registration fee), Junior League (8-9 year olds games in Ogdensburg-Heuvelton-Lisbon $15 registration fee), and Senior League (10-12 year olds games in Ogdensburg-Lisbon $15 registration fee). Six-year olds have option to play in Little Kickers or Farm League.

Additional forms available at www.lisbontownrec.com.

Anyone wishing to sign up can send completed application with fee by August 18th to Tori Richardson 311 Wood Road Lisbon, NY 13658. Check payable to Lisbon Town Clerk. Payment must accompany form for the child to be placed on a team. Any questions please call Tori Richardson at 854-1946 or lisbonreccoordinator@gmail.com.

LISBON RECREATION SOCCER REGISTRATION

Please check the level your child will participate in:

______ Little Kickers - $7 (4,-5 year olds, play in Lisbon)

______ Farm League - $10 (6-7, year olds, play in Lisbon)

_____________ Junior League - $15 (8-9 year olds, games in Ogd. & Lisbon)

______ Sr. League - $15 (10, 11 & 12 year olds, games in Ogd. & Lisbon) _____$25 Family Limit

PLEASE NOTE: JR. & SR. LEAGUE AGE BRACKETS ARE SET BY THE OGDENSBURG KIWANIS LEAGUE, AS A GENERAL RULE THEY DO NOT ALLOW PLAYERS TO MOVE UP UNLESS THEY ARE NEEDED TO COMPLETE A TEAM. Additional forms available at www.lisbontownrec.com

Player’s Name: ________________________________________ Age: ______

Date of Birth:__________________________ Grade (Sept. 2012):__________

Address: ____________________________________________________________

____________ _____________________________________________________

Parent Contact #:___________________ Phone____________

Email Address: ________________________________________

WAIVER AND RELEASE: In consideration of the acceptance of this application, we the undersigned for ourselves, our heirs, executors and administrators agree to be legally bound to the terms and conditions herein after set forth:

I hereby give our consent and approval for the participation of the applicant in the program conducted by the Lisbon Recreation Department and certifies that he/she is physically fit to take part in all activities. Further, we do hereby waive, release and forever discharge said organization, its staff, representatives, employees and their successors and assigns from any and all claims for damages occurring during the applicant’s participation in the soccer program, whether said accident, injury or loss due to negligence or not.

I, _______________________________ (parent/guardian), give my permis

sion for _________________________(child’s name) to participate in the Fall Soccer program sponsored by the Town Recreation Committee. I understand that Junior and Senior Level teams participate in the Kiwanis Soccer program in Ogdensburg. These teams and coaches will be selected on or around August 18th, 2012. All registration forms received after this date will be assigned to teams based on the number of participants each team has.

Please list all medical problems or allergies: _____________

Signed: _______________________________ Date: _________

Are you interested in coaching? ______________

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