Children must be at least age 5 and no older than 13 by August 1, 2015
Players & Coaches register online at www.oceanbeachsoccer.com
First Name: ______________________________Last Name: _________________________ Sex: M / F
Birth Date: ___________________ Address: ________________________________________________
Parent/Guardian Name(s): _______________________ Email: _________________________________
Primary Phone: ________________________ Secondary Phone: _______________________________
Medical Issues and Treatment: ___________________________________________________________
Physician Name & Phone: _______________________________________________________________
Special Requests (coach/teammate): ________________________________________ [Not guaranteed]
Practice Field Preference (Mark 1 st ,2 nd , 3 rd ): _____ OP _____ LB _____ Ilwaco____ Chinook ____ Naselle
I, the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of OBYSL, its affiliated organizations and sponsors. Recognizing the possibility of physical injury associated with soccer and in consideration for OBYSL accepting the registrant for its soccer program and activities (the “Programs”), hereby release, discharge, and/or otherwise indemnify OBYSL, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized for the registrant’s participation in the program and/or being transported to or from the same, which transportation I authorize. As parent or legal guardian of the above-named player, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb, or well-being of my dependent.
By reading this, I understand that Ocean Beach Youth Soccer League follows a Zero Tolerance Policy for assault and abuse, and
OBYSL will not condone game misconduct, including: negative comments directed towards any player, spectators instructing players on the field, and negative comments directed towards a referee or coach.
______________________________________
Parent/Guardian Signature
2015 Fee Schedule
______________________________________
Parent/Guardian Name
______________________________________
Date
Before July 10 th
Single Player Two Players Three Players
$35.00 $65.00 $95.00
From July 11 th & 31 st $45.00 $85.00 $125.00
DISCOUNT APPLIES TO IMMEDIATE FAMILY ONLY
Returning Player:  Y  N
Are you interested in volunteering?
 Coaching  Committees  Board
 Field Preparation  Assistant Coaching
Must be able to pass background check
Want to help sponsor a child to play? Any $$ amount will help!
Registration Fees (first player) ...................... ________
Registration Fees (additional players)........... ________
Sponsorship donation ................................... ________
Total ........................................................... ________
Coaches will call you with practice times mid to late August
Questions??? Contact Robyn at oceanbeachsoccer@gmail.com