HICKORY GROVE UNITED METHODIST CHURCH

YOUTH REGISTRATION FORM FOR

Soccer

 

Mission Statement: To provide a Christian recreational atmosphere for fellowship and fun, to learn and to grow in our mission to inspire, reach and support Hickory Grove and surrounding communities.

Please print:

_________________________________________________________________________  Girl: ____ Boy: ____

Child’s First Name                                                               Last Name

 

____________________________________________________________________ Check all that apply:

Street Address                                                                                                                                    Member  _____

                                                                                                                                                                Non-Member_____

____________________________________________________________________ I would like more

City                                                             State       Zip                                                                      information about HGUMC____

____________________________________________________________________       Registration Requirements

E-mail address Home                                           Work                                                                                     

1 - Completed form

_____________­­­­­_______        __________________________      ­­­­­­­­­_______________    2 – Registration Fee

Child’s Home Phone #            Date of Birth                                     Current Age                          

                                               

_____________________________________________________________________________________________   

Father’s Name                                      Cell/Work #                           Mother’s Name                                    Cell/Work #

 

Medical Information about the child:

Medications regularly taken:                                                                                                                                                            

Reason for taking medications:                                                                                                                                                        

Allergic reactions:  Bee Sting: ___________  Penicillin: __________  Other:                                                                        

Any specific activities to be restricted?                                                                                                                                          

Other health information:                                                                                                                                                                   

 

I, the undersigned parent or legal guardian of the above named child, hereby gives approval to his or her participation in any and all of the activities of the program during the current season.  I assume responsibility for the transportation of my child to and from activities.  I further understand that neither the participating church nor the league in which the candidate participates, carries medical insurance and in the event my child is injured during any activity related to church or league play, I am solely responsible for any medical bills incurred. I understand that my child will be ineligible to practice and play in this sports program until a copy of the birth certificate is provided, a completed registration form is on file and registration fees have been paid. Misrepresentation of a child’s age or birth date will result in his or her suspension from the league. Each participant must sign the player’s code of conduct attached to this form or available for download from the Internet.

 

I have provided accurate medical information on my child and understand that medical expenses incurred while participating in this sport are my responsibility.

 

Parent or Guardian Signature: ________________________________________________Date: ________________

FEE AMOUNT DUE WITH REGISTRATION:                                              

Age groups: Under 7 Clinic Ages 4-6 (not 7 before 10/15)         $35.00   After 9/15 $45

Under 9 League Ages 7-8 (not 9 before 10/15)                               $65.00   After 7/31 $75

Make checks payable to HGUMC Recreation.               

FIANCIAL ASSISTANCE IS AVAILABLE. YOUR REQUEST WILL BE KEPT CONFIDENTIAL.

Shirt Size: (Please check one)

Youth  ____ S     ____ M    ____ L      ____ XL

Adult  ____ S      ____ M    ____ L      ____ XL    ____ XXL

 

 

All coaches and players participating in sports with Hickory Grove UMC will promote Christian sportsmanship by both words and actions. This contract is to be signed and stapled to the registration form.

Player’s Code of Conduct:

As a team member representing HGUMC, I will:

Do my best to conduct myself in a Christian-like manner at all times. Show respect for all coaches, umpires, officials and team members. Not use profanity or display a bad attitude. Give my best to my coach and team during all practices and games. Take care of any uniform or equipment issued to me. Do my best to be on time for all practices and games. Keep my ball fields clean by putting all trash in the trash bins. I understand that if I fail to abide by this contract, my coach has the right to restrict my playing time as the consequence for violating this contract. If violations continue, the coach has the right to dismiss me from the team.

 

Player’s Signature:                                                                                                               Date:                                      

 

Parent’s Signature:                                                                                                              Date:                                      

(if player is under 18 years of age)

 

 

 

The recreation department at Hickory Grove United Methodist Church would like to extend an offer to our membership, their families, and all non-members participating in our recreational programs with an opportunity to serve through volunteer efforts.

 

Please check the volunteer opportunities that interest you:

__________ Coaching Youth Sports                                                              __________ Officials

__________ Coaching Adult Sports                                                               __________ Scorekeepers

__________ Interested in helping with a team but not as a Head Coach __________ Concessions- gym or fields

__________ Individual Sports Coordinator

Concession stand work at:

__________ Speedway Races (May) __________ Auto Fair (April and Sept.)                    

               

 

 

 

 

Recreational questions should be directed to Recreation Ministries at the main church number, 704-537-4686, extension 45. Recreation Ministries, Hickory Grove UMC, 6401 Hickory Grove Rd., Charlotte, NC 28215

email rec@hgumc.com