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Lisbon Fall Soccer Signups

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LISBON - The Lisbon Town Recreation Committee is announcing its final registration deadline for their fall youth soccer program. The final sign ups will be held on Saturday from 9 – 11 a.m. at the Lisbon Town Recreation Concession building. Registration forms must be received by August 17th so teams can be assigned. Any form received after August 17th will be charged a $5 late fee per player. Forms can be accessed at http://lisboncs.schoolwires.com/Page/1066

All forms and fees must be received before a player will be put on a roster.

Please send completed form with fee to The Lisbon Recreation Committee: Att: Recreation Coordinator, PO Box 98, Lisbon, NY 13658. Check payable to Lisbon Town Clerk. Any questions please call Tori at 854-2916.

———————————————

LISBON FALL SOCCER REGISTRATION

______ Little Kickers - $7.00 (4 & 5 year olds, play in Lisbon)______ Farm League - $10 (6 & 7 year olds, play in Lisbon)______ Jr. League - $15 (8 & 9 year olds, games in Ogdensburg and Lisbon)______ Sr. League - $15 (10, 11 & 12 year olds, games in Ogd. & Lisbon)

Note: there is a $25 Family Limit

PLEASE NOTE: AS A GENERAL RULE PLAYERS are not TO MOVE UP AN AGE BRACKET UNLESS THEY ARE NEEDED TO COMPLETE A TEAM.

Player’s Name: ______________ Age: ___ Male/Female (circle)



Date of Birth: ____________________Grade (Sept. 2013):___________



Address: __________________________________________________________



Parent Contact Name: ________________Contact #:__________



Email Address: ______________________________________

PERMISSION SLIP

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 permission 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 17th, 2013. 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_______assistant coach:___________



Payment Received:_____Cash:____Check #_____

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