aysa

AYSA Sport Registration Form

Player Name:

Address:

Date of Birth:

Current Grade:

Age as of September 1st:

Father's Name:

Father's Phone Number:

Father's Email:

Mother's Name:

Mother's Phone Number:

Mother's Email:

LIST ANY MEDICAL PROBLEMS OR PROHIBITION PLAYER HAS:

Preferred jersey # (first come basis)

Sport: choose from the drop down below

*** Please Note***

MEDICAL RELEASE

CONSENT FOR MEDICAL TREATMENT (MINOR)

Address:

Phone #:

I give permission for my child's photograph or name (not both together) to be electronically produced and displayed on the Abbott Youth Sports Association website and Facebook page.

Code of Conduct/Equipment

Parent Signature:

Player Signature:

Coach/Team Manager Volunteer

Name:

Phone Number:

I would like to volunteer to be:

I would like to volunteer for the following sport:

Coaches shirt size:

Other info you would like us to know.

Code of Conduct/Equipment:

Signature:

Sponsor Form

Business Name (as it should appear on jersey)

Contact Person

Phone Number

Email:

I would like to sponsor the following team for $150:

Other info we need to know:

Please contact Kaylie Matula at 254 659-7233 with any questions.

Shirt Size