Priscilla Step 1 of 5 20% Sports Choice(Required) CCSL Soccer CCSL Volleyball Age Group Player will play in for Soccer(Required) Middle School - Age 10-13 as of June 1st High School - Age 14-18 as of June 1st Young Adult - Age 19-35 as of June 1st Age Group Player will play in for Volleyball(Required) Middle School - Age 10-12 as of June 1st Junior Varsity - Age 12-14 as of June 1st Varsity - Age 15-18 as of June 1st Young Adult - Age 19-35 as of June 1st NOTE: Want to play up? Click Here for conditions where this is allowed/not allowedPlayer Name(Required) First Last Gender(Required) Male Female City(Required) City Primary Email(Required) For league and coach communicationPrimary Cell Phone(Required)For league and coach communicationPlayer Date of Birth(Required) MM slash DD slash YYYY Chaldean Church You Attend (Parish)(Required)-select-Holy CrossHoly MartyrsMar AddaiMother of GodOur Lady of Perpetual HelpSacred HeartSt. GeorgeSt. JosephSt. PaulSt. ThomasGrade Entering into Fall(Required)-select-56789101112College or Post High SchoolEntering School in Fallplayers current schoolTell us your experience in this sport(Required) New to organized sport Recreational (play for fun) Club School Years of Experience(Required)0 - 1 year2 - 3 years4+ yearsList club/school(Required) Jersey and Teammate RequestJersey Size(Required)-select-Youth SmallYouth MediumYouth LargeYouth X-LargeAdult SmallAdult MediumAdult LargeAdult X-LargeAdult XX-LargePlease ensure correct youth/adult selection. Sizes are based on standard t-shirts.Would you like to request teammate(s) or a Coach?(Required)-select-YesNo(You may request up to 2 teammates to be on your team. We will try but cannot guarantee.)Coach or Captain RequestCoach/Captain Request Yes No Coach/Captain NameTeammate RequestPLEASE NOTE: * ALL LISTED PLAYERS MUST REQUEST EACH OTHER IN ORDER TO BE CONSIDERED * REQUEST ARE NOT GUARANTEED. WE WILL DO OUR BEST * YOU MAY REQUEST UP TO 2 TEAMMATES TO BE ON YOUR TEAM. WE WILL TRY BUT CANNOT GUARANTEE.Teammate Request 1 First Last Relation to Player - Teammate 1 Sibling Carpool Friend Other Teammate Request 2 First Last Relation to Player - Teammate 2 Sibling Carpool Friend Other Primary Parent/Guardian Name(Required) First Last Primary Parent/Guardian Cell Phone(Required)Primary Email(Required) Additional Parent/Guardian Name First Last Additional Parent/Guardian Cell PhoneEmergency Contact Name(Required) First Last Different from aboveEmergency Contact Cell Phone(Required)Different from above Parent Release FormAllergies / Health Conditions(Required)-select-YesNoDoes the player have any allergies, medication, or health conditions?List any medications, allergies, or health conditions.(Required)Parent Release(Required) By clicking this checkbox you agree/accept the followingI request that my child be allowed to participate in the Chaldean Church Sports League. In the event of an emergency or should my son require medical assistance, I authorize the adults in charge to seek such assistance and treatment. If such an incident should occur, I release from any liability: my parish and its staff, the Dioceses of St Thomas, the organizers, chaperones, and other adults responsible for running this program. I understand that the St Thomas Chaldean Diocese does not provide accidental/medical insurance for the child named above. Medical bills, including prescription drugs, will be the responsibility of the parent or guardian of the child. When participating in this league, our child may be photographed during any time participating in this league. I also understand the Player Code of Conduct for my child, listed below, and at any time these codes are not respected and followed, my child may be dismissed from this league.Code of Conduct(Required) By clicking this checkbox you agree/accept the followingI (participant) pledge to be responsible for my participation by following the Player Code of Conduct of the St Thomas Chaldean Diocese Youth Group Soccer League. _____I agree to play in a positive manner, reflecting Christian values at all times. _____I agree to practice good sportsmanship at all times. _____I agree to attend & participate in all scheduled games & practices when possible. _____I agree to be aware of safety & will follow team & league rules to ensure safe play. _____I agree to my coach’s authority & will participate & communicate positively with my coaches & teammates. _____I agree to treat fellow players, opponents, fans, & officials with respect. _____I agree to exercise self-control at all times, refraining from foul language, & setting a positive example for others to follow. _____I agree to support & encourage my teammates, & I will always try my best to keep a positive attitude. _____I agree to attend one of the Diocese’s youth programs. Consent(Required) By clicking this checkbox you agree/accept the following* Practices will be held within a 20 minute radius of the church you play for * Practice times and days will be dependent on and determined by the coach * I understand that my child will be placed on a team according to the criteria decided by the leagueParent/Player Email(Required) Name of player or parent (if minor) filling out this form (Electronic Signature)(Required) First Name Last Name By typing my name here, I, the player or parent/guardian (if minor), confirm that I agree with all the terms. I also have communicated the CODE of CONDUCT with player (if minor). Here is a quick summary of the registration Player Name: {:1.3} {:1.6} Sport: {Sport:53} Age Group: {Soccer Age Group:56} {Volleyball Age Group:79} Jersey Size: {Jersey Size:13}Coupon CodeSoccer Registration Cost Price: Soccer Registration Cost Price: Soccer Registration Cost Price: Volleyball Registration Cost Price: Volleyball Registration Cost Price: Volleyball Registration Cost Price: Volleyball Registration Cost Price: PaymentCredit CardCard Details Cardholder Name Billing Zip Code ZIP Code Total Δ
