RCYS.com

   Registration    
         

Fall 2007

        
         
Fill out the form below.  When finished, print this page by going to your File Menu and selecting "Print."  You can not submit this form online, it must be mailed to the registrar.  This form, along with your registration fee of $50 should be mailed to:
  Cale Worley
4697 S Runion Rd.
Rushville, IN 46173		    
 

Checks payable to: Rush County Youth Soccer

 
     
         

Name:
D.O.B.:
Age:
Address:
City:
ZIP:
Parent's name(s):
Parent's D.O.B.:
Home phone:
Email address (not required):

By submitting this information, I give my permission for my son / daughter to participate in this program. I understand that practices may or may not be held immediately following school’s dismissal and I will be able to provide or arrange transportation to/from practices. I understand games are held on Saturday mornings, afternoons and Sunday afternoons, I will be able to provide or arrange transportation to/from games. I understand that my son / daughter is expected to be at as many practices and games as possible.