Volunteer Soccer Coach Form

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Spring 2024

Thank you for volunteering to coach our Spring 2024 youth soccer program! This program would not be possible without your support. This form serves to:

1) CONFIRM your coaching availability AND
2) REGISTER (via this Google Form) or REFUND you for your child's registration (one child plays for free as a thank-you for your time)

Any additional children who will be playing will need to be registered normally. Regular registration begins January 3rd and closes April 1st (or as soon as program fills).

Spring 2024 Soccer Details:

Coaches' Meeting: Monday, April 15th @6:00pm at the PCC. Equipment & uniform pick-up.
Begins week of April 30 (4/30 -6/15) Game rain date: 6/22

No Saturday Games Memorial Day Weekend (5/25)
Practices: Tuesday, Wednesday, or Thursday; Games: Saturday 8:45am - 11:15 start times
Fridays reserved for rain makeup practices

Coed grades K-1 – Fellows Road
Coed grades 2-3 – Center Park West fields #3 & #4
Coed grades 4-5 – Potter Park

Email *

Your first and last name *

Child's first and last name *

League selection (224721) *

Grades K-1 (AA, AB, AC) Your child must be currently enrolled in Kindergarten or 1st grade

Grades 2-3 (BA, BB, BC)

Grades 4-5 (CA, CB, CC)

Practice night selection (224721) *

Tuesday (AA, BA, CA) - No more coaches needed for K-1 and 2-3

Wednesday (AB, BB, CB) - No more coaches needed for 2-3

Thursday (AC, BC, CC)

To help us create fair and balanced teams, please answer the following questions.

What school does your child attend? *

How many seasons has your child played for the Perinton Recreation and Parks Soccer League?

Does your child play on a travel team?

Yes

Clear selection

Please share the general amount of soccer experience your child has.

Beginner

Intermediate

Advanced

Clear selection

What size t-shirt does your child wear?

Youth Small

Youth Medium

Youth Large

Youth Extra Large

Adult Small

Adult Medium

Other:

Clear selection

Phone number *

Household address *

Name of other coach you would like to be paired with

What size t-shirt do you wear? Sizes are men's and women's fit and range from adult small through adult XXXL.

Please list any other players you would like to be on your team. Requests not listed here cannot be guaranteed.

Please read and initial below: I hereby release the Perinton Recreation and Parks Department and any of its staff from any responsibility or liability in connection with this activity. I give permission to a licensed physician or other hospital staff members to carry out emergency medical care deemed necessary to myself/child/ward when normal permission is unavailable. I certify that I am in good physical health and have no limitations other than those I have listed below which may predispose me to risk during this program. I also fully realize that I must provide proper hospitalization. The Town of Perinton does not provide accidental insurance coverage. I have read and understand the department’s refund policy. In the event a refund is granted for myself or for my child for whatever reason with the stated activity, I do hereby authorize the Town of Perinton to execute a refund voucher on my behalf and submit for payment under the terms and conditions set forth in the Town of Perinton Refund and Registration Policy. *

Send me a copy of my responses.

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