Back Next

 

 

Website: www. newtownsoccerassociation.com

Newtown Soccer Association

Club Director: Fran Rubert

2002 Beacon Hill Drive

Holland, PA 18966

(215) 860-6115

                                          

 

For:                              Boys and girls, ages 4 to 12 years old; must be 4 by April 1 and not 13 before April1, 2012.

When & where:      On Sundays from April 1 to June 3, 2012 at the Newtown Middle School Fields .Off Easter and Memorial

                                        Day weekends.

Players ages 4 and 5           1:00 PM to 2:00 PM                   Players ages 9 to 12            3:00 PM to 4:00 PM

Players ages 6 to 8               2:00 PM to 3:00 PM                  

Cost:                      $80 per player, $85 late registration FOR ANY REGISTRATION COMPLETED AFTER March 15, 2012. (includes, shirt, shorts and socks and participation award at end of season)

 

Registration:        Please complete form below and mail to: Newtown Soccer Association, 2002 Beacon Hill Drive, Holland PA 18966. YOU WILL NOT BE CONTACTED UNLESS THERE IS A PROBLEM.

Refund Policy:       In the event that the program is canceled, you will receive a full refund. No refunds/credits will be issued when a player fails to attend or drops out of the program.

If you would like to be a volunteer coach, please indicate so on the registration form.

 

 

 

 

"

Registration Form

Name

 

 

 

 

 

 

Birth Date

 

 

 

Address

 

 

 

 

 

 

Spring    Fall

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4 and 5 age group

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6 to 8 age group

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 9  to 12age group

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Home phone

 

 

 

Work phone and Email address.

 

 

 

 

 

 

 

Medical insurance carrier (Child must have medical insurance to participate)

Make checks out to Newtown Soccer Association

 

 

 

 

 

 

 

 

Fee $

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Policy or group number

 

 

 

 

 

 

 

 

 

paid in cash

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

paid by check

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Release:

I release the Newtown Soccer Association from all claims, which may result from my, or my child’s participation in the above program.  As parent/guardian, I grant permission to a physician or hospital to provide emergency medical care to aid my child or myself in connection with the above program.

 

 

 

Signature

 

Date

 

 

 

 

 

 

 

 

 

 

I would like to be a volunteer coach

 

 

 

 

 

 

Name and phone number(s):