Genola Youth Soccer

Player #1 Information

First Name *

Last Name *

Please select one *

If your child already has a jersey, you can skip down to the next question. If you need a jersey, please fill out this section.

New jerseys are $20. New socks are $6.

Please indicate the size below.

Jersey Size

Socks

Yes, my child needs a new pair of socks.

Gender *

Male

Female

Date of Birth *

Upcoming Grade in School *

Playing age as at start of season *

Residence in league boundary? *

Yes

No

Player #2 Information

First Name

Last Name

Please select one

Socks

Yes, my child needs a new pair of socks.

If your child already has a jersey, you can skip down to the next question. If you need a jersey, please fill out this section.

New jerseys are $20. New socks are $6.

Please indicate the size below.

Jersey Size

Gender

Male

Female

Date of Birth

Upcoming Grade in School

Playing age as at start of season

Residence in league boundary?

Yes

No

Player #3 Information

First Name

Last Name

Please select one

Socks

Yes, my child needs a new pair of socks.

If your child already has a jersey, you can skip down to the next question. If you need a jersey, please fill out this section.

New jerseys are $20. New socks are $6.

Please indicate the size below.

Jersey Size

Gender

Male

Female

Date of Birth

Upcoming Grade in School

Playing age as at start of season

Residence in league boundary?

Yes

No

Family Information

Home Phone *

Cell Phone Number

Family Email Address

Street Address *

Address Line 2

City *

State *

Zip Code *

Coaching soccer can be a rewarding experience. Everyone who coaches will receive a refund for one child's fees (excluding uniform costs) when they return the equipment to the city.

Father's Name

Father Can Help As

Mother's Name

Mother Can Help As

If you or your child would like to ref. please enter your information below. Refs are paid per game.

Name and phone number