Player's Name- First: Middle I: Last Name:Gender: M \ F

Jersey Size: YXS YS YM YL AS AM AL AXL A2X

Shorts Size: YXS YS YM YL AS AM AL AXL A2X

Home Phone: ( ) - Cell Phone: ( ) - Email(s):

Mother's Name:Home Phone: ( ) - Cell Phone: ( ) - Mother's Email(s):

Father's Name:Home Phone: ( ) - Cell Phone: ( ) - Father's Email(s):

(Not-For-Profit Organization)

= $ 85 per player= $ 95 per player= $100 per player

*Players that played Fall 2018 only owe $20 for Spring RegistrationNon-refundable registration fees: U5-U8 (born 2011-2014)

U10-U12 (born 2007-2010)U14-U19 (born 2000-2006)Please make checks payable to "Coast Soccer Club "

PROOF OF AGE REQUIRED: Y / N | if yes: DATE: / / INITIALS:

:FOR CSC OFFICIALS USE ONLY:

CASH ______ CREDIT ______ CHECK #________________ AMOUNT DUE $ ________________ TOTAL RECEIVED $ ________________

Name: _______________________ ______ Relation: ________________________ Phone #'s: ( __ ) __ - __ As the parent/legal guardian of this player, I hereby give my consent for emergency medical treatment by a medicalprofessional to preserve life/limb or well being in my immediate absence.

Parent Name: Signature: Date:

Agreement with the Coast Soccer Club No parent/child will be allowed to pick a specific team or coach, except as provided by the CSC Constitution and By-

Laws. I authorize the league to take and utilize photographs of my child during organized CSC activities for promotional use. Registration with CSC is a BINDING AGREEMENT that the player has an obligation to fulfill their

requirements as a registered member in the duration for the program that they have completed this registration for. *We regret any inconvience, but CSC maintains a NO REFUND policy.*

Parent Name: Signature: Date:

Player's School: Grade:

Player's Primary Contact Information:

COAST SOCCER CLUB*For Additional Information or online registration options, please visit: www.CoastSoccerClub.org

2018 - 2019 SPRING Recreation Registration

Birth Date (MM/DD/YYYY):Name that Player preferrs to be addresed as (Nickname):

State:

Previously registered with CSC? Yes No

Address: City: Zip Code:

Does the player participate in other extra-curricular activites?

Alternate Emergency Medical Contact: (*other than above* )

*NOTICE: Coast Soccer Club acknowledges that players aged 16+ will have the options and / or responsibilities of driving themselves to andfrom Evolution Sessions. However, CSC cannot bear any responsibilities pre-arrival or post-departure.