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Maize Recreation Soccer Registration Form
Return to: MRC, P.O. Box 205, 10100 Grady Ave., Maize, KS 67101
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Name:
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Boy
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Girl
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Age & D.O.B.:
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Address:
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City, State, Zip
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Grade:
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School:
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Home Phone:
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Cell Phone:
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E-Mail Address:
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Parent/Guardian (if minor):
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Emergency Name &
Phone Numbers:
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Special Medical Information:
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Shirt Size:
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Youth Small 6-8
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Youth Medium 8-10
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Youth Large 10-12
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AS
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AM
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AL
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AXL
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Attend Free Soccer Clinic
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Coach you would like to play for:
(NO FRIEND REQUEST)
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Would you like to coach this year?
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Do you play in another league? If so, where?
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Payment Options:
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Check (if mailing form in)
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To pay by PayPal or credit card, click the store link on the Online Registration page
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Participants MUST live in USD 266 boundaries or go to school in Maize. If it is discovered that
a player does not meet the requirement, they will be dismissed from the league, no refund and
the team will forfeit all games.
A team will only have a limit of two players that participate in another league. If it is discovered
that there are more than two players from other leagues, the team will forfeit all games.
Participants must be at least in kindergarten to play. A participant may play up one grade
level. If a participant plays up, they must remain there for the entire season.
Release: I acknowledge that by my signature below, the registrant listed above is participating
in the Maize Recreation Commission (MRC) programs at his/her own risk. MRC, Maize USD
266, City of Maize, successors and assigns shall not be held liable for any accidents, illness,
injury or damage to property. MRC does not provide any medical insurance for participants.
Parents/Guardians are responsible for insurance. Parents must sign for children, 18 and
under, entering program. Registration not valid without signature.
Model Release: The undersigned and participant authorize the Maize Recreation Commission
to use at its discretion any photograph(s) taken of the participant while participating in any
activity and waive any and all claims that the participant or the undersigned or their heirs,
executors, administrators, or assigns may have or claim to have resulting from such
photograph(s) or reproductions thereof.
Medical Release: In case of a medical emergency and I cannot be contacted; I give my
permission for a MRC representative to act in my place and to make medical decisions
concerning emergency treatment for the participant. I understand that the MRC staff is not
allowed to administer any medications.
Conduct: The undersigned and participant agree to abide by all the policies and guidelines set
forth by the MRC regarding this program and violations could result in being expelled from the
activity with no refund.
I, the undersigned, have read this release and understand all its terms. I execute it voluntarily
and with full knowledge of its significance.
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I have read the above release &
accept.
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Date:
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