Spring 2024 Soccer Registration
Tentative Game dates:  TO BE DETERMINED, BASED ON WHEN THE SNOW MELTS ;-)
Sign in to Google to save your progress. Learn more
Email *
I would like to register my player for: (includes late registration fee) *
25 points
Player's First Name *
Player's Last Name *
Player's Gender *
Grade in school (2023-2024 school year) *
Player's Shirt Size (Jerseys tend to run small) *
My player has played soccer: *
My player CANNOT practice on the following days *
Required
Parent/Guardian's First and Last Names *
Address *
City *
Parent/Guardian Phone Number *
Allergy/Medical issues (please include food allergies) *
Other helpful information/ accommodations needed (we will do our best to honor them, but make NO promises) *scheduling needs of ALL players and balancing teams will take priority over requests for specific teams or coaches 
I will pay for a snack pack for my kids team. Snack packs are $15 each and are a FUNDRAISER for EYSA. Every kid on the team will get a snack and drink, delivered to the field. Please pay at the time of registration *
15 points
Does your player need cleats? Cleats are $6 per pair *
6 points
Does your player need shin guards? (size S, M, L) Shin guards are $5 per pair *
5 points
Does your player need soccer socks? Socks are $4 per pair *
4 points
My player needs a gear bag. Bags are $5 each *
5 points
Captionless Image
Would you like a bag tag? Tags are $5. This item is customized
5 points
Captionless Image
Clear selection
Would you like a soccer school supply case? $5 each (limited stock) This item is customized *
5 points
Captionless Image
Would you like a water bottle? Bottles are $10 each. *
10 points
Captionless Image
Would you like a window decal? Decals are $1 each *
1 point
Captionless Image
Would you like a bracelet? Bracelets are $1 each *
1 point
Captionless Image
Do you want an EYSA tumbler (about 20oz) with lid $15 each? *
15 points
Captionless Image
Would you like beanie hat? Hats are $15 each (one size fits most) *
15 points
Would you like a fleece stadium blanket? Blankets are $20 New design coming soon from our new vendor *
20 points
Captionless Image
Would you like a baseball hat? Hats are $20 each 
Logo is embroidered into hats
*
20 points
Captionless Image
Would you like an umbrella? Also works for creating shade ;-) Umbrellas are $20 each *
20 points
Would you like a tote bag? $20 each *
20 points
Would you like a duffle bag? Bags are $35 *
35 points
Captionless Image
Parent Volunteer Opportunities *
Required
Please list your business/organization sponsor or other volunteer request below (Recommended sponsorship is $100 or more)
Please type your name below, acknowledging that you agree to the following. (This will be taken as an "e-signature".) I request that you accept the registration form of this child in the Edgerton Youth Soccer Association for the dates specified on the brochure. In consideration of your acceptance of the registration, I release Edgerton Youth Soccer Association, its volunteers, coaches and the board members from all claims on the account of any injuries which may be sustained while attending the practices and games. I agree to indemnify and hold EYSA, its volunteers, coaches and board members harmless for injury and expense including costs of defense which may result from activities associated with participation in this program. If medical attention is required for injury or illness for the participant, I give my permission for such medical care and take full responsibility for payment of such medical care. I understand that volunteers will be taking pictures, and my child may be captured in images. These pictures will be used for publicity and fundraising on the EYSA website, Facebook, Twitter, and volunteer websites. *
I agree to the Edgerton Youth Soccer Association Parent/Coach Code of Conduct, as found here: Code of Conduct *
50 points
COMMUNICABLE DISEASE RELEASE OF LIABILITY & ASSUMPTION OF RISK AGREEMENT In consideration of being allowed to participate, at the sole discretion of the Edgerton Youth Soccer Association ("EYSA"), I, the undersigned, acknowledge, appreciate, and agree that: I understand that this Waiver is an important legal document, and that I have a right to ask questions regarding this Waiver, bargain/negotiate the terms of this Waiver, and review this Waiver with an attorney. I confirm that I have carefully read this Waiver, that the terms of this Waiver are acceptable to the Participant and me, if I am signing on behalf of the participant, and that I am knowingly and voluntarily waiving any right that I or the Participant may have to bargain for different terms by signing this Waiver. I understand that if any portion of this Waiver is held to be invalid, the balance shall continue to be in full force and effect. I am aware there are risks to me of exposure directly or indirectly arising out of, contributed to, by, or resulting from an outbreak of any and all communicable disease, including but not limited to, the virus “severe acute respiratory syndrome coronavirus 2 (SARS-CoV2)”, which is responsible for Coronavirus Disease (COVID-19) and/or any mutation or variation thereof. Because COVID-19 is extremely contagious and is spread mainly from person-to-person contact, EYSA has put in place preventative measures to reduce the spread of COVID-19. I understand EYSA cannot guarantee that its employees, volunteers, other participants, sponsors, advertisers, or others in attendance will not become infected with COVID-19. I agree to self-monitor for signs and symptoms of COVID-19 (symptoms typically include fever, cough, and shortness of breath) and, contact EYSA if I experiences symptoms of COVID-19 within 14 days after participating at a Sanctioned Event with EYSA. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS THE EDGERTON YOUTH SOCCER ASSOCIATION, its officers, officials, agents and/or employees, other participants, volunteers, sponsors, advertisers, and, if applicable, owners and lessors of premises used to conduct the event (RELEASEES), from any and all claims, demands, losses, and liability except for those for harm caused intentionally or recklessly, arising out of or related to any ILLNESS, INJURY, DISABILITY OR DEATH I may suffer related to participation in the Sanctioned Activities, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. Participant Signature: Date: FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE (UNDER AGE 18 AT TIME OF REGISTRATION) This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liability incidents to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law *
Registration Payment (your total will be your 'score' at the end (your total/279) ) will be sent via:
Players will not be placed on a team until payment is made.
PayPal
Venmo: Turn OFF purchase protection
Square: $3 processing fee will be added
Check: Drop off at 415 Fairfield Cir
*
3 points
Total score
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy