Pleasure Island Soccer Association PO Box 1868, Carolina Beach, NC 28428
Rec Registration-Fall '19
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Summer Academy Registration
6-week Summer Conditioning & Skills Program - $125
Summer Academy Begins Monday June 17 for kids born 2007-2013
*Due to field repairs at Carolina Beach, Summer Academy will be held at Veterans Park
Indicates required field
Select Birth Year Below
Grade this Fall
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Email will be used as primary communication. Make sure address is typed correctly.
By clicking the Submit button below, you agree to have read the following Liability Waiver & Medical Consent.
You will then be directed to the online payment page to complete the registration process.
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.
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.
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.
Submit Academy Registration