todddyaa

Delaware Youth Athletic Association P.O. Box 1601 Delaware, Ohio 43015 Website: WWW.DYAASoccer.org Email Address: admin@dyaasoccer.org


ON-LINE REGISTRATION FOR ANY DYAA REC PLAYER

Complete EVERY QUESTION on the registration form …then submit your payment as instructed. Registrations must be completed by January 9th, 2012 to guarantee placement.
Player’s FIRST Name:	*
Player’s LAST Name:	*

2.GENDER: Please type in Boy or Girl	*
Player’s Date Of Birth:
Month:	*
Day:	*
Year:	*

3. Choose the Player’s Grade level in school this coming spring:	*	PK K 1st 2nd 3rd 4th 5th 6th 7th 8th

4. Player’s Address:	*
City:	*
Zip Code:	*

5. Name of parent(s) or guardian:	*
Cell Phone:
Evening Phone:	*
Day Phone:

6. Email Address used only for communication by DYAA)	*

7. Has the Player played before: Please check one:	*	No Yes

IF YES, SELECT how many seasons of experience:		1-2 3-4 5-6 over 6

Did the player play in the fall 2011 season.	*	No Yes

IF YES, Type the COACH's NAME from the fall 2011 season.

IF YES, Please type the color of the players uniform from the FALL 2011 SEASON.

8.Teams are Single Sex Teams, divided by grade levels: PK/K...1st...2nd/3rd...4th/5th... and 6th/7th/8th
(6th,7th and 8th graders play in the Middle School Soccer Association -MSSA).

Does the player have a sibling of the same sex who would be playing on the same age level team?
Please choose:		No Yes

If YES, TYPE the sibling's name here
BUT REGISTER each sibling separately (they will be placed on the same team)

9. Player’s Registration Fee: Place a CHECK MARK in the appropriate line below according to the player’s grade level in school this coming spring. The registration fee includes all league fees, insurance, field and equipment fees, season-ending memento (trophy, medallion, etc) referee fees and league administrative costs. SUBMIT THE PAYMENT AMOUNT SHOWN BELOW.
Please Select:	*	Pre-K or K Boy or Girl playing in DYAA Rec league $67.00 1st Grade Boy or Girl playing in DYAA Rec league $67.00 2nd or 3rd Grade Boy or Girl playing in DYAA Rec league $77.00 4th or 5th Grade Boy or Girl playing in DYAA Rec league $77.00 6th, 7th or 8th Grade Boy or Girl playing in DYAA MSSA Rec league $120.00 (plays in Middle School Soccer Association League)

10. Player’s Uniform Fee: Players purchase their uniform separately (not included in the above the registration fee). If the player played in the fall 2011 season, they will use the same jersey that they purchased for the Fall 2011 season (because they will be on the same team for the Spring 2012 season) If the player did not play in the fall 2011 season or if they lost or out-grew their fall jersey then select the appropriate size to make your purchase. If you are going to coach and want to purchase a matching uniform, please also make your selection below.

11. Player’s Shirt Size:
Indicate the size that you would like ordered for the player (coaches purchasing a uniform should also indicate their size) Youth sizes 16.00 and Adult sizes 17.00
Please select:		YS ($16) YM($16) YL($16) AS($17) AM($17) AL($17) AXL($17) A2XL($17)



REGISTRATION DEADLINE: I understand that registrations after January 9th, 2012 cannot be guaranteed unless there is an opening in the player's age group.

I do Understand the registration deadline.	*	YES

14. As a volunteer-based organization, we need your help to accommodate the large numbers of players. The minimum age for each coaching position is 18. The minimum age for a referee is 13 yrs old.

Head Coach: prepares, coordinates and runs practices and games; communicates practice and game schedules; conducts parent/player meetings as appropriate Note: Your child's regitration fee is waived BUT you still purchase the player's uniform (and coach's uniform if desired)

Note: IF YOU WANT TO BE THE HEAD COACH OF YOUR SON'S OR DAUGHTER'S TEAM, YOU SHOULD PRINT OUT THE REGISTRATION FORM AND MAIL IT TO DYAA WITHOUT PAYING THE REGISTRATION FEE...BUT YOU STILL MUST PAY THE UNIFORM FEE WHEN YOU MAL IN THE FORM. MAIL TO DYAA, PO BOX 1601, DELAWARE, OH 43015

Co-Head Coach: serves as a Co-Head Coach with another, sharing the Head Coaching duties (you will be paired up with another Co-Head Coach). Note: ONE-HALF of your child's registration fee is waived since duties are shared BUT you still purchase the player's uniform (and a coach's uniform if desired)

Note: IF YOU WANT TO BE A CO-HEAD COACH OR YOUR SON'S OR DAUGHTER'S TEAM, YOU SHOULD PRINT OUT THE REGISTRATION FORM AND MAIL IT TO DYAA AND PAY ONE-HALF OF THE REGISTRATION FEE...PLUS THE UNIFORM WHEN YOU MAIL IN THE FORM. MAIL TO DYAA, PO BOX 1601, DELAWARE, OH 43015

Assistant Coach: (helps the Head Coach on the field when available). Note: No fees are waived. Write your name here if you wish to be an Assistant Coach.
Your Name:

Team Administrative Assistant: (helps the coach make phone calls, team mailings) Write your name here if you wish to be an Administrative Assistant.
Your Name:

Referee (of 2nd – 5th grade games): Write your name here if you wish to be a referee for Rec. Games. Refs. are paid $15.00 per game and must be at least 13 years old with significant playing and/or reffing experience.
Your Name:

Payment Calculator: Your registration and Payment will not be process unless all questions are completed in full AND unless payment calculator is accurately completed and full payment returned with this form. ONLY USED IF YOU ARE MAILING THE REGISTRATION

Registration Fee: __________
Player Uniform Fee: __________
Coach Uniform Fee(if desired) __________
Total payment being made: _________

15. AUTHORIZATION: On behalf of all participants in my immediate family I/we have read and agree to abide by the DYAA Code Of Conduct (which can be obtained on the DYAA web site at www.DYAASoccer.org). Furthermore, in consideration of my/our entry and registration of the player/participant hereby enrolled in the Delaware Youth Athletic Association and its youth soccer program, I/we and my/our legal heirs, individually and as the parent(s)/legal guardian(s) of the player/participant, do hereby waive and release all rights and claims for losses or damages that I/we and the player/participant may have against the City of Delaware and the Delaware Youth Athletic Association, its officials, sponsors, hosts, representatives, and administrators, for any and all injuries suffered by me/us and/or the player/participant in connection with participation in this program and all its events. I/we and the player/participant assume all risks of injuries, losses, and damages in connection with such participation. There is a $5.00 on-line registration fee included in this price to help offset bank charges.

By checking this box I agree to this Authorization:	*	YES

Total:	*