Recreation Registration

Recreation Registration - Spring 2021
DEADLINE JANUARY 15

* Indicates required field

Player Information

Player Name *

First

Last

Gender *

DOB *

Jersey Size *

Team Placement Information

School *

Grade *

Played Fall 2020 *

YES NO

Coach LAST Name *

Parent Information

Parent Name *

First

Last

Cell *

Street *

City *

Zip *

1st Email *

2nd Email *

Sign-up to COACH

I would like to coach this team. *

YES NO

Coach Name *

First

Last

Cell Phone # *

Sign-up to SPONSOR
$250 for Age 3,4,5 or $300 all other ages
> Get your child's registration fee waived! (save up to $110!)
> Get your business name on the team jerseys
> Get your logo/ad on our website
> Get your business a tax deduction

I Would Like To Sponsor a Team: *

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 related 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

*Refund Policy:
Upon registering a player, immediate costs are incurred by PISA including insurance, jersey & screen-printing.
> Before January 15: $35 non-refundable administrative fee applies
> After January 15: No Refunds unless child cannot be placed on a team by the 1st week of games.
There are no credits or refunds for withdraw after January 15 due to COVID concerns other than what is stated below.

COVID 2021 Policy: Credit-only policy due to Civil Authority cancellations
If civil authority requires us to cancel prior to 1st week of games. a 75% Credit can be applied to the following season.
If civil authority requires us to cancel any time after 1st week of games, no credit or refunds are available.