Brownsburg Junior Soccer League USAI - Brownsburg Community ...

Brownsburg Junior Soccer LeagueUnited Soccer Alliance of IndianaCome join our family & experience the Fun & ExcitementFall 2013 Registration -Brownsburg Junior Soccer LeagueBoys & Girls Ages 3-18Tuition assistance available for qualified familiesTraining and Games:USA of Indiana Brownsburg Soccer Complex3400 N. County Road 600 E., Brownsburg orUSA of Indiana Avon Soccer Complex6050 E. County Road 9 1N, AvonTrained coaches, great fun, player development.Pictures and awards for each player.Rec players receive FREE trophy and pictures.REGISTER NOWSoccer Tots / U4 $75U5, U6 $90U7, U8 $100U10 $105U12 115*All Fall 2013 players buy newuniform for $25, not included inregistration.3 WAYS TO REGISTER1. ONLINE: www.USAindy.org2. In Person:Saturday, Sept 7, 9am-11amNorthwestway Park Snack Bar5253 W. 62nd St, Indianapolis, IN 462683. Mail: Complete & Mail in this form to:Brownsburg Rec Soccer RegistrationPO Box 532472Indianapolis, IN 46253HOTLINE –317-767-0699EMAILUSAirec@unitedsoccerallianceindiana.orgUSA of Indiana offers partial tuitionassistance program for families inneed. We provide the bestenvironment for the youth of ourcommunity through fun, fair play, andplayer improvement. Avon-Fusion RecSoccer - USA of Indiana knows noboundaries. Anyone can experiencethe joy of soccer regardless of income.

3 WAYS TO REGISTER:1) FILL OUT THIS FORM AND:MAIL TO: Brownsburg Rec Soccer Registration, PO Box 532472,Indianapolis, IN 462532) REGISTER ONLINE AT www.USAindy.orgTuition (per child) $Uniform if needed $Volunteer Buyout $TA/RAF $Total Due $Amt Pd: Ck#: Cash:3) VISIT US DURING AN IN-PERSON REGISTRATION EVENTSaturday, Sept 7th, 9am-11amNorthwestway Park Snack Bar5253 W 62nd St, Indpls, 46268Location (circle one): Pike Hendricks CountyLast Name: First Name: MI:Street Address:City/State/Zip:Email:Home Phone:Please Circle: BOY GIRL Date of Birth: / / Age:Uniform Sizes – Please CircleJersey XS YS YM YL YXL AS AM ALSchool Attending:Parent/Guardian Name:Shorts XS YS YM YL YXL AS AM ALGrade:Phone:Relationship:Any known health problems, allergies or special needs? Please report to coach at start of season.The player’s parents and/or legal guardian(s) hereby consent and agree USA of Indiana/Pike Youth Soccer Club Inc, its officers, directors, commissioners, coaches,other volunteers, and Indianapolis Parks and Recreation Department will not be liable for any injury sustained by the player while participating in any club activityand that such entities and persons have no responsibility for lost, stolen or damaged property. In addition I hereby give permission to the representatives of USA ofIndiana to render first aid and obtain any medical treatment necessary to be administered until the parent/guardian(s) may be contacted. I also hereby assume theresponsibility for payment of any aid or treatment. I also understand each family is expected to volunteer at last 3 hours each season. Exceptions require a $25 buyout during Registration. I have read, understand, and agree to USAi of Indiana's, code of conduct.SignatureDateAll USA of Indiana programs are volunteer supported. Please consider volunteering today.