WEIRTON ROTARY YOUTH
SOCCER LEAGUE
Fall 2011 – Spring 2012 Open Soccer Registration
Click here for copy of registration form
Player+Membership+Form+1-4-2011
Playerregform.Pennsylvania2011
PlayerTeamStatusForm.Pennsylvania2011
WRYSL
Registration Form
**** WV STATE REQUIRES ALL NEW PLAYERS TO SUBMIT A COPY OF A BIRTH CERTIFICATE WITH THEIR REGISTRATION.
LEGAL LAST NAME _____________________________________________________________________________
LEGAL FIRST NAME ____________________________________________________________________
STREET ADDRESS ____________________________________________________COUNTY___________________
CITY, STATE, ZIP ______________________________________________________________________________
PHONE NUMBER ________________________________ ALTERNATE NUMBER______________________________
DATE OF BIRTH ________________________________________________________ MALE_______ FEMALE_____
E-MAIL ADDRESS _______________________________________________________________________________
MOTHER’S NAME _______________________________ FATHER’S NAME __________________________________
ALLERGIES AND/OR MEDICAL CONDITIONS __________________________________________________________
EMERGENCY CONTACT OTHER THAN ABOVE _________________________________________________________
PHONE NUMBER _______________________________________ RELATION ________________________________
UNIFORM SIZES (PLEASE CIRCLE)
SHIRT: YS YM YL AS AM AL AXL AXXL
SHORT: YS YM YL AS AM AL AXL AXXL
REGISTRATION FEES: Age 5 - $40 UNDER 8 - $60 UNDER 10 - $65 UNDER 12 - $70 UNDER 14 - $70 (CHILDS AGE AS OF AUGUST 1, 2011)
DEDUCT $5.00 FROM ABOVE PRICE FOR ALL PLAYERS WHO COMPLETE A REGISTRATION FORM AND RETURN BY MAIL TO: WRYSL P.O. Box 2028 Weirton, WV 26062
**** OHIO AND PENNSYLVANIA RESIDENTS MUST PAY AN ADDITIONAL $15.00 AND MUST DOWN LOAD OUT OF STATE FORMS AT WWW.WEIRTONSOCCER.ORG AND MAIL WITH REGISTRATION.
REGISTRATION DATES: April 23 10:30 - 1:00 SATURDAY
May 11 5:30 - 8:00 WEDNESDAY
May 21 10:30 - 1:00 SATURDAY
PLACE: J.C. WILLIAMS SOCCER COMPLEX 995 COLLIERS WAY WEIRTON, WV
FINAL REGISTRATION MUST BE POSTMARKED BY MAY 28, 2011. ANY REGISTRATIONS RECEIVED AFTER THIS DATE WILL BE PLACED ON A WAITING LIST AND WILL BE CHARGED A $20 LATE FEE.
ANY QUESTIONS PLEASE CONTACT BONNIE MINGER, REGISTRAR, AT 304-527-0294.
PARENTS SIGNATURE ________________________________DATE ____________