Bay Area Soccer League
Rec League Resgistration
P.O. Box 1111
Sandusky, Ohio 44871-1111
|
Coach Registration |
Season : spring 2010 |
| Coach: |
|
|
|
| |
First Name |
Last Name |
|
| Address: |
|
|
|
| |
|
|
DOB |
| |
|
,
|
(01/01/1949) |
| |
|
|
Gender |
| Phone: |
|
|
Male |
Female |
| |
Home (Example 419-555-5555) |
Work or Cell |
|
| eMail Address: |
|
|
Type of Coach |
| Age Group: |
DOB for Age
Groups |
|
Head Coach |
| Player Requests: |
|
Coaching Request |
Asst Coach |
| |
|
|
|
| |
|
|
|
| |
|
|
|
LIABILITY RELEASE |
I agree that I the registrant
will abide by the rules of the USYSA, its affiliated
arganizations and sponsors. Recognizing the possiblity of
physical injury associated with soccer and in consideration
for the USYA accepting
the registrant for its soccer programs and activities (the"Program"),
I hearby realease, discharge and/or otherwise indemnify the
USYSA, its
affiliated organizations and sponsors, their employees and
associated personnel, including the owners of fields and
facilities utilized for the
Programs and/or being transported to or from the same, which
transportation I herby authorize.
|
CONSENT
FOR MEDICAL TREATMENT |
| I hereby
give consent for emergency medical care prescribed by a duly
licensed Doctor of Medicine or Doctor of Dentistry. This care
may be given under whatever conditions are necessary to preserve
life, limb or well-being of myself should I not be able to respond. |
COACHING
AGREEMENT |
| As an OYSAN
registered coach, I hereby agree to follow and uphold all of
the rules and regulations of the
above named league, the Ohio Youth Soccer Association North and
US Youth Soccer. I also understand that if
I do not follow these rules and regulations, I will be subject
to sanctions by my league or state association for my
actions. In addition, I have signed and sent the Kidsafe
Disclosure Statement. KidSafe Program, to the State
Office. (This form is obtained through the League Registrar or
by download at www.oysan.org). I discharge
and/or otherwise indemnify the organization/league/club for which
I am registering to coach, Ohio Youth Soccer
Association North, its affiliated sponsors, employees and associated
personnel, including the owners of fields
and facilities utilized against any claim by or on behalf of myself
as a result of my participation. |
| |
| By signing below
you agree to abide by our liability release, give consent for
medical treatment as specified above, and acknowledge our coaching
agreement. |
| |
| ____________________________________ |
_______________________________ |
| Coach's Signature |
Date of Signature |
| |
|
|
|