AYSO
Region 557
P.O. Box 102
Flintville, TN
931-937-8004 x800
2009 Player Registration Form
season starts August 1

$60 per child      $110 for 2 siblings     $150 for 3 siblings
 
Fill out the form below. At the end, click to record the information. The printed form will be available at
South Lincoln Recreation or Fayetteville Recreation
for signing and payment during regular in-building signups,
(dates and times to be announced on our home page)
 
 Gender Boy Girl
 Birth Date*        Player's age not specified
  Play up one league**  No League
   *NOTE: A Birth Certificate may be required to complete signup for AYSO Region 557
**NOTE: Approval by the AYSO Region 557 Soccer Board is required for a child to play up one league
 
Player Information
 First Name    Last Name
 Middle Initial  Suffix  Nickname
 Address
 Zip  City  State
 Home Phone School Name: 
 Years Played   Practice  Previous Coach
    NOTE: When you choose a practice field, it does not mean that you will absolutely practice at that 
           park. When coaches volunteer, we give them the choice of where to practice. Team
           formation is designed to give everyone a chance to play and this may mix players from both
           parks. This is the AYSO credo. Games will be played at the most convenient park to support  
           our referees.
 Email
   Hearing impaired  VIP (children with disability)  AYSO mailings
 
 Siblings please list all brothers and sisters that are also playing soccer in AYSO this year
 
 Travel Issues
 
 
Guardian 1 Information
 Relationship    Gender Male Female
 First Name    Last Name
 Middle Initial  Suffix  Home Phone BtnCopy1
 Address BtnCopy1
 Zip BtnCopy3  City  State
 Occupation    Cell Phone
 Employer    Bus. Phone
 Email BtnCopy6
 I want to volunteer for:  Coach   Assist Coach   Referee   Linesman   Other
  NOTE: Last year we missed going to tournament because we did not have enough referees and linesman
           to be guaranteed a berth in the games. This year, all U8-U16 teams must have two parents trained
           to stand in as linesman (and preferably a center referee). Please volunteer so our kids are allowed
           to go to tournament should they qualify.

           ALL VOLUNTEERS MUST FILL OUT a "Volunteer Application"
 
 
Guardian 2 Information
 Relationship    Gender Male Female
 First Name    Last Name
 Middle Initial  Suffix  Home Phone BtnCopy7
 Address BtnCopy8
 Zip BtnCopy7  City  State
 Occupation    Cell Phone
 Employer    Bus. Phone
 Email BtnCopy12
 I want to volunteer for:  Coach   Assist Coach   Referee   Linesman   Other
  NOTE: Last year we missed going to tournament because we did not have enough referees and linesman
           to be guaranteed a berth in the games. This year, all U8-U16 teams must have two parents trained
           to stand in as linesman (and preferably a center referee). Please volunteer so our kids are allowed
           to go to tournament should they qualify.

           ALL VOLUNTEERS MUST FILL OUT a "Volunteer Application"
 
 
Emergency Medical Information
 Contact    Phone
 Relationship    Doc. Phone
 Ins. Carrier    Policy No.
 Physician
YES NO   Are there any disabilities, handicaps, injuries or limitations, allergies, hemophilia,
  heart condition, history of respiratory illness, or any other medical condition?
 If yes, state problem
 
 
Uniform Information
 Pick the requested SHIRT size: Unspecified
 Youth Sizes:   Extra Small Small Medium Large
 Adult Sizes:   Small Medium Large Extra Large
 Pick the requested SHORTS size: Unspecified
 Youth Sizes:   Extra Small Small Medium Large
 Adult Sizes:   Small Medium Large Extra Large