Rec Hurricanes- Spring 2023

Recreation / Hurricanes Registration - Spring 2023

THIS FORM IS ONLY FOR CURRENT HURRICANES PLAYERS WHO ARE
CURRENTLY ON A SPRING 2023 HURRICANES TEAM AND ALSO PLAYING RECREATION.

$95 = 1st-4th Grades
$105 = 5th grade and older

HURRICANES PROGRAM TAKES PRIORITY
REC GAMES MAY CONFLICT WITH HURRICANE EVENTS AND WILL NOT BE RESCHEDULED

* Indicates required field

Player Information

Player Name *

First

Last

Gender *

DOB *

Jersey Size *

Team Placement Information

Played Fall 2022? *

YES NO

Coach's LAST Name *

School *

Grade *

Parent Information

Parent Name *

First

Last

Cell *

Street *

City *

Zip *

1st Email *

2nd Email *

DO YOU WANT TO COACH?

WE NEED COACHES IN ORDER TO HAVE A TEAM! Benefits of coaching YOUR child's team include: 1) Choice of Practice Day & Time that is best for you, 2) $10 BWW Gift Card, 3) Coach's Shirt. Offer valid for 1 coach per team. DO YOU WANT TO COACH YOUR CHILD'S TEAM? *

YES NO

Your Name *

First

Last

Email *

Cell Phone # *

DO YOU WANT TO SPONSOR?
Grades 1-12 = $300. Grades Pre-K & Kindergarten = $250

Benefits of Sponsoring your child's team include: 1) YOUR child's registration fee is FREE 2) Your business name on team jerseys. 3) Your logo/ad on our website for 6 months. 4) Your tax deduction. *Once your sponsorship is paid, we will refund your child's registration fee. DO YOU WANT TO SPONSOR THIS TEAM MY CHILD IS ON *

YES NO

Business Name *

Contact Number *

Liability Waiver & Medical Consent

We/ 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 including any COVID-19 or other sickness or bodily injury, and understand there is no medical insurance that applies. I/we agree that any photos taken of players for player cards, team photos or action photos I give consent to PISA to use for website and purposes for exhibit & promoting PISA programs. I understand there are no refunds of registration fees if season is cancelled due to circumstances out of the organization's control, whether natural or by government or other entity's orders that prevent us from holding activities.

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.

By clicking the Submit button below, I agree to have read the Liability Waiver & Medical Consent above.
I understand my child is not registered to participate until payment is made immediately upon submitting this player form.
(you will be directed to payment page)

Submit & Proceed to Payment

Recreation Refund Policy:

Upon registering a player, immediate costs are incurred by PISA including insurance, jersey & screen-printing.
> Before July 31: $35 non-refundable administrative fee applies
> After July 31: No Refunds unless child cannot be placed on a team by the 1st week of games.

Player Information

Team Placement Information

Parent Information

DO YOU WANT TO COACH?

DO YOU WANT TO SPONSOR? Grades 1-12 = $300. Grades Pre-K & Kindergarten = $250

Liability Waiver & Medical Consent

Recreation Refund Policy:

DO YOU WANT TO SPONSOR?
Grades 1-12 = $300. Grades Pre-K & Kindergarten = $250