2022 YMCA Fall Soccer Registration Form
Registration is now OPEN for the Plattsburgh YMCA's Youth Soccer Program. 

9/6/22 - PLEASE NOTE:  REGISTRATION is now closed for our younger 3 divisions. WE ARE ONLY TAKING REGISTRATION FOR OUR PASSERS DIVISION:  10-12 year olds. 

Ages:  3 to 12 years
Dates:  September 10 - October 29
Times:  Saturdays (see play times below)
Location:  Y on the Oval fields

Kickers Division:  3-4 year olds (@ 9:45 - 10:45 am)
Shooters Division:  5-6 year olds (@ 9:45 - 10:45 am)
Dribblers Division:  7-9 year olds (@ 8:30 - 9:30 am)
Passers Division:  10-12 year olds (@ 11:00 am - 12:30 pm)

Registration Fee:  $55 Members/$110 Community Members
***Registration Fee includes a soccer ball and team shirt

If you are registering more than one child, you will need to complete a separate form for each child.

Please note:  We are not able to accommodate specific team or coach requests.  If you are carpooling or rely on another player's family for transportation, please note that in the Special Considerations section of the form and we will accommodate the request IF we are able to do so.

There are no refunds for cancelled registrations.

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Email *
Are you interested in being a Coach or Assistant Coach? *
Player's First and Last Name *
Date of Birth *
Address *
Division *
Shirt Size *
Player's Skill Level *
Parent's Name *
Parent's Phone Number *
Special Considerations
Please note if there are any special considerations, we should know about your child below.  (Example:  physical limitations, disability, medical conditions, allergies, etc.)
Name on Credit Card *
Credit Card Number *
Credit Card Type *
We only accept Mastercard or Visa
Expiration Date *
CVV Code *
Participation Authorization & Photo Release *
By typing your name in the space provided below, you certify that your child is of normal health and capable of participating safely in the YMCA Youth Sports Program.  You also give permission for photographs to be taken of your child for the purpose of explaining the program and future program promotions.
A copy of your responses will be emailed to the address you provided.
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