ROCKET SPORTS
2ND SESSION HOUSE SOCCER LEAGUE REGISTRATION FORM
224 County Line Road, Wayne, PA 19087        610-293-0888      info@rocketsports.com

This form MUST be accompanied by your non-refundable registration fee
($100 if postmarked by January 18, $120 if postmarked after January 18)

Name Of Registrant: Telephone: (               )
Address: Sex:       Male   /   Female
Town, State, Zip: E-Mail Address:
Parent's Names: Birth Date (year, month, day):

CIRCLE DESIRED DIVISION FOR THE REGISTRANT
Age Group
Game Times Age Group Age Group 
Saturday mornings: Boys Kindergarten Boys Grade 1 Girls Grades K & 1
Saturday late mornings & early afternoons: Boys Grade 2 Girls Grade 2  
Saturday afternoons and early evenings: Boys Grades 3 & 4 Girls Grades 3 & 4  
Sunday late mornings & early afternoons: Co-Ed Grades 5 & 6 Co-Ed Grades 7 & 8 High School Co-Ed

CAR POOL / TEAMMATE REQUESTS - Please list any car pool or teammate requests below. Teammate requests MUST be playing in the same division as the registrant. We will make every effort to honor requests. Please note that we do NOT guarantee such requests. Requests received after January 18 will most likely NOT be honored.


COACHING VOLUNTEERS - If you have prior experience as a youth soccer coach or as a player and would like to coach, please volunteer below:

Name Of Volunteer:Coaches E-Mail Address:
 
Division Requested:Previous Coaching:

RELEASE / AUTHORIZATION STATEMENT

Note: This Statement MUST be signed by parent or guardian for a minor and by coach or administrator for himself / herself.

I, the parent/guardian of the registrant, a minor, or adult registrant of legal age, agree that I and the registrant will abide by the rules of Rocket Sports. Recognizing the possibility of physical injury associated with sports activities and in consideration for Rocket Sports accepting the registrant for their sports programs and activities (the "Programs"), I hereby release, discharge and / or otherwise indemnify Rocket Sports, their affiliated organizations and sponsors, employees and associated personnel, against any claim by or on behalf of the registrant as a result of the registrant's participation in the Programs.

Parent / Guardian Signature: Date: ____  ____  ____

AFTER YOU REGISTER - Please check our web page (www.rocketsports.com) and check our list of registered players to be sure we have you assigned to the correct division. Our web page will list your team assignment, coach and game schedule about a week before the start of the season. Rocket Sports will NOT call you with this information.