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Putnam County Youth Soccer Association
Recreation League Player Registration, Spring 2017

 Complete both sides of the top half of this form and submit appropriate fee by March 3rd
Little Kickers $35, All other ages 1st player $85 (with $25 concession stand fee), each additional player $55
 There is a $25 Concession Stand fee per Family included in the fee for the 1st player (see above)
 After March 3rd, pay the late registration fee (add $10 to regular fee)
 No registrations will be accepted past March 13th
 Mail forms to: PCYSA, PO Box 952, Greencastle, IN 46135: checks payable to PCYSA
 Register online at www.pcysa.com. Online registration offers Monthly Payment Options &
Multiple Child Discounts. Please contact the club treasurer at [email protected] for more
information
Player #1 Information
Name
___________________________________
Date of
Birth
____/____/_____
MM/DD/YYYY
Address
__________________________
Gender:
M ___ F _____
__________________________
Home
Phone
_____________
Parent/Guardian
Name(s)
Email Address
Age __________
Grade ________
Shirt Size
___________
Cell Phone
____________
______________________________________________________________
________________________________________________________________________
Does this player have other siblings playing this season? Y____ N___
Siblings Names: ___________________________________________
Spring 2017 Age Groups:
 5U(Little Kickers): children born in 2014, 2013 and 2012
(See Instructions below on how to figure your child’s age grouping)
 7U: children born in 2011 and 2010
 9U: children born in 2009 and 2008
 11U: children born in 2007 and 2006
 13U: children born in 2005 and 2004
 15U: children born in 2003 and 2002
** *Indiana Soccer has changed the way the age groups are determined their formula is as follows: You take the year of the
Spring Season that is to come and subtract the year of the child’s birth. This will give you the age group that the child falls
under. ***
Recreational League soccer is PCYSA’s intramural soccer division. It consists of teams from 5U (Little Kickers) to 15U (Under-5 to
Under-15). Players will be placed on teams based on their ages. Rec League soccer is an instructional league with emphasis on fun
and development. If you have any questions, please contact Rec League Coordinator Jamie Smith by e-mail at
[email protected] .
The first 2017 Spring Season soccer game will be held on April 8th, 2017. The season will be played on 7 weekends (7 games for
5U/7U/9U/ 11U/15U). All games will be held on Saturday mornings at the Big Walnut Sports Park. The 5U age group, Little
Kickers, will ONLY play on Saturdays. They will not have practices during the week. All other teams will practice once a week
beginning the week of March 13, 2017 as weather allows.
Team assignments: Siblings will be assigned to same team IF they are at the same level. Any parent who coaches will be placed with
his or her child. No other special request (relating to friends, transportation, favorite coach, etc.) will be considered.
Medical and Conduct Waiver (your child may not play until this is signed): I hereby acknowledge that my child may be injured by
participating in this sport. I am aware that there is no Benefit Fund for participants in this program, and I agree to assume personal
responsibility for any injuries that my child may suffer. I do hereby release and discharge PCYSA and their respective agents, officers,
coaches and all volunteers, Big Walnut Sports Park, City of Greencastle, and Greencastle Community Schools from all claims, demands, or
damages due to any injury. In the event of a medical emergency, I hereby give my consent for a PCYSA representative to obtain medical
treatment for the player named on this form. I, the undersigned, acknowledge that PCYSA will hold myself and any guest that I may invite to
Big Walnut Sports Park responsible for any actions that may violate he Code of Conduct that PCYSA has posted at www.pcysa.com.
_________________________________________________________
____________________________________
Parent or Guardian Signature
Date
WE NEED YOUR HELP! Please choose one or more of the options below.
Head Coaching _____
Assistant Board Member _____
I am interested in:
Coaching
_____
Fund Raising _____
Concession Stand _____
Referee
Other __________________
_____
(refs paid
by age
group)
Team sponsors are needed! (Contact [email protected] for pricing)
______
Yes, please contact me about sponsoring a team for one or two seasons (Spring and Fall).
Business Name ______________________________________
Phone Number ________________________________
Contact Name _______________________________________
Billing Address _______________________________
Donors and Player Sponsors are also needed!
______
Yes, please contact me about sponsoring one or more players so that they can play in the league.
______
Yes, please contact me about making a financial donation to PCYSA.
Please Detach the Bottom Portion of This Form and Keep for your records.
--------------------------------------------------------------------------------------------------------------------------------------2017 Spring Season Calendar
Feb. 5th – Regular Rate Registration Opens
Mar. 5th – Regular Rate Registration Ends
Mar. 6th – Late Registration Opens
Mar. 12th – Coaches Meeting
Mar. 13th – Late Reg. Ends/Practices Can Start
Apr. 8th – Game #1
Apr. 15th – Game #2
Apr. 22nd – Game #3/ Picture Day #1 (age Groups TBD)
Apr. 29th – Game #4/Picture Day #2 (Age Groups TBD)
May 6th - Game #5
May 13th – Game #6
May 20th – Game #7