2017 Fall Soccer Registration Age divisions determined by DOB on October 31, 2017. Games will be played Monday-Thursday behind Berrien Springs Middle School during the months of September and October Games start at 6:00. 4/5 & 8-10 play Monday/Wednesday & 6/7 play Tuesday/Thursday. The 11/12 age division are traveling teams. Some games will be played at surrounding communities. Forms and payment are due by Friday, August 18th. $20.00 late fee after this date. Practices for 4-10 year olds will take place the weeks of September 11 and September 18. Opening Day will be Games will be Sunday, September 24th. All teams will play a game and have team pictures taken./li> Flat soled shoes or soccer turf shoes must be worn, shin guards are recommended. Please no special request; the GBSRD will do their best to set up fair teams. Any questions contact the GBSRD office at 471-2732 or email email@example.com. Coaches are needed. Programs can't run without volunteer coaches! Registration fee is due at the time of form submission. Your form will not be processed without payment. Upon submitting this form you will be taken to the payment page to enter your credit card information. Registration fee: $48.00 (age 4-10) $58.00 (age 11-12) Family rate: (Age 4-10) 2 Children $80.00 3 Children: $105.00 Family rate: (Age 11-12) 2 Children $100.00 3 Children $135.00 Family rate: 1 Child (4-10) + 1 Child (11-12): $90.00 *$20.00 late fee if paid after Friday, August 18th, 2017 *$10.00 if not a resident of Village of BS, Oronoko Township, or Berrien Township All Fields Required Last Name First Name Male or Female. MaleFemale Age Weight Height Birthdate Street Address City Email Primary Phone Additional Phone Grade School Resident Of: Berrien TownshipOronoko TownshipVillageOther Does the above named participant have health insurance? YesNo Mothers Name Fathers Name Emergency Contact (Name & Number) Shirt Size Youth Med.Youth LargeAdult SmallAdult med.Adult largeAdult xlAdult xxl Coaches and Umpires are needed. If you are able to coach please fill in your name and phone number below. Please specify if you would like to head coach, assistant coach, or umpire. Please specify your shirt size. By submitting this form I the parent/guardian of the above named participant hereby, give approval for my child's participation in the Greater Berrien Springs Recreation Department activities for the sport indicated on this form. I assume all risks and hazards incidental to such participation. I do hereby agree to waive and hold harmless the Greater Berrien Springs Recreation Department Board and its agents from any claim arising or injury to my child. Also, I have read the GBSRD Code of Conduct, and Agree to follow its guidelines.