Peak Soccer Registration Peak Soccer Registration Participant Name*FirstLast Address* Street Address City State Postal / Zip Code Birth Date* Age* Gender Entering Grade:(0=Pre/K)* # Years Played* Last year played (grade in school)* Ordering a new Jersey?*YesNo If reusing your jersey, please enter the number: Participant's shirt size if ordering a new Jersey:*Youth SYouth MYouth LAdult SAdult MAdult L Medical Conditions- Please be specific and how you want the coach to handle. Type NONE if so.* Comments/ Scheduling Conflicts or Concerns- Type NONE if so* Peak Soccer's goal is to promote sportsmanship. If there is a Major conflict you'd like us to to consider, please list Parent/Guardian #1*FirstLast #1 Phone* #1 Email* Parent/ Guardian #2FirstLast #2 Phone #2 Email Emergency Contact #1*FirstLast Emergency Phone #1* Emergency Contact #2*FirstLast Emergency Phone #2* Each Parent will be asked to volunteer to make the season run the best it can. Coaching= 1-2 days a week (2 for U11-U14) plus Saturday games.*Head CoachAssistant CoachTeam Manager: email, etcLine Fields: Fri b/f home gameConcessions: home gameGoal net help: 1-3 daysLinesman: (u11 + only) Shirt Size- Head Coach only*Adult SAdult MAdult LAdult XL Add Player #2*YesNo Participant Name(#2)*FirstLast Birth Date(#2)* Age(#2)* Gender(#2) Ordering a new Jersey?(#2)*YesNo If reusing your jersey, please enter the number (player#2): Participant's shirt size if ordering a new Jersey:(#2)*Youth SYouth MYouth LAdult SAdult MAdult L Entering Grade:(0=K)(#2)* # Years Played(#2)* Last year played (grade in school)(#2)* Parent/ Guardian #2(Player#2)FirstLast #2 Phone(Player#2) #2 Email(Player#2) Medical Conditions- Please be specific and how you want the coach to handle(#2)* Comments/ Scheduling Concerns(#2) Peak Soccer's goal is to promote sportsmanship. If there is a Major conflict you'd like us to to consider, please list(#2) Add Player #3*YesNo Participant Name(#3)*FirstLast Birth Date(#3)* Age(#3)* Gender(#3) Ordering a new Jersey?(#3)*YesNo If reusing your jersey, please enter the number (player#3): Participant's shirt size if ordering a new Jersey:(#3)*Youth SYouth MYouth LAdult SAdult MAdult L Entering Grade:(0=K)(#3)* # Years Played(#3) Last year played (grade in school)(#3) Parent/ Guardian #2(Player#3)FirstLast #2 Phone(Player#3) #2 Email(Player#3) Medical Conditions- Please be specific and how you want the coach to handle(#3)* Comments/ Scheduling Concerns(#3) Peak Soccer's goal is to promote sportsmanship. If there is a Major conflict you'd like us to to consider, please list(#3)Please click the link and read the Code of Conduct and Liability Waiver for yourself and your player(s). Sign and agree by entering your name below.Player Code of ConductLiability Waiver I give permission for my child to be included in TEENS, Inc. media*YesNo Parent: By entering my name, I agree to the Code of Conduct and Liability Waiver, and I answered the Media question*FirstLast Player #1: By entering my name, I agree to the Code of Conduct and Liability Waiver*FirstLast Player #2: By entering my name, I agree to the Code of Conduct and Liability WaiverFirstLast Player #3: By entering my name, I agree to the Code of Conduct and Liability WaiverFirstLast Payment Choice- Pay by Check*check Registration: Director will confirm registration and email you total and payment directions*1st Player: $801st Player: $40 Head Coach Only2nd Player: $753rd Player: $65New Jersey: $35 eachLate Fee (after 7.31): $20SubmitReset