2022 Youth Winter League Registration

Parent name *

Email *

Phone *

Address *

Address Line 1

City

State

Zip Code

Parent interested in coaching? *

Yes
No

Player name *

Player date of birth *

Player age *

Player Gender *

Female
Male

If applicable, please select which club your child plays for

Cajun Rush
LYSA
SSYS/Dynamo

Players you would like to play with

Request not guaranteed.

Coach you would like to play for

Request not guaranteed.

Pelican Park/Carencro Sports Complex Amateur Waiver/Release of Liability

I have read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement. *

First

Last

Please enter first and last name to agree to and accept the waiver above.

2022 Youth Winter Soccer League *

Price: $ 60.00

Date / Time

Date

Time

Email *

About the Author: Garnet Thibodeaux

Hello world!