Intent to Play-Juniors Spring 2020

Junior Hurricanes: Intent To Play Fall 2021 Season:
(This form is for 2010/11 Boys & Girls ONLY)

Spring 2020 season is $580 - all inclusive
3 tournament entry fees, all coaching fees/travel
$275 Player Registration Fee is due immediately to guarantee your position on the team roster no later than June 1
4 monthly payments of $100 will be due on the 1st of each month beginning January 1, final payment on April 1.

By completing this form, you are accepting the position on the team roster and agree to the terms below.
Form and registration fee deposit must be received by Dec.1 to guarantee your place on a team.
After Dec.1 positions will be opened up to new players trying-out.

* Indicates required field

(BE SURE ALL REQUIRED FIELDS ARE COMPLETED)
Player Information

Player Name *

First

Last

Played Hurricanes Fall 2019 *

YES NO

Gender *

Date of Birth *

Grade *

Uniform Size (new players only) *

Street *

City *

Zip Code *

Parent/Guardian Information

Parent Name *

First

Last

Cell Phone *

Primary Email *

2nd Email *

Player Participation & Payment Agreement - Liability Waiver

I, as the parent/legal guardian of the player named above, do hereby declare our intent to allow this child to practice, play, and participate in all programs and activities associated with the Pleasure Island Soccer Association, including any related activities and transportation. We/ I hereby release and hold harmless from any and all liability; Pleasure Island Soccer Association, its coaches, sponsors, associated board members and personnel, officials, or any others associated with this organization against any claim by or on behalf of the player’s participation in this program.

We/ I do hereby authorize Pleasure Island Soccer Association or any representatives including coaches, officials, or anyone associated with this organization, if after reasonable attempt has been made to reach the designated parent/guardian named above to consent, or if sound medical practice decrees that there is not time to make such an attempt, to consent to any x-ray, anesthetic, medical or surgical diagnosis or treatment or hospital care, to be rendered to the player under the general or special supervision and on the advise of any physician, dentist or surgeon duly licensed to practice, be indeed rendered to the Registrant.

We/I understand there are hard costs associated with this program and for my child to play, and we/I agree to pay the player participation fee for our child in the amount outlined in the estimated player budget of $580 for the season. Once registered, a non-refundable fee equal to $220 will be assessed for player commitment / start-up and administrative costs to register your player. We/I understand actual costs may fluctuate slightly from the original estimated budget based on actual costs and number of tournaments entered, other games played, rained-out events; but agree regardless to reimburse (Pleasure Island Soccer Association, Inc.) PISA for any monthly dues owed as explained in the team budget for the Season, and agree to payment in full on or before April 1, 2020.

By clicking the Submit button below, you agree to have read the Player Participation Agreement.

I agree to the terms described above. *

YES - I Agree to the terms

I Agree & Submit Form

(BE SURE ALL REQUIRED FIELDS ARE COMPLETED)Player Information

Parent/Guardian Information

Player Participation & Payment Agreement - Liability Waiver

(BE SURE ALL REQUIRED FIELDS ARE COMPLETED)
Player Information