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Youth Coaching Certification
2017-2018 Registration Fees
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2017-2018 SOCCER REGISTRATION (CLICK HERE)
Player's First Name:
Player's Last Name:
School Grade (Sept. 2017):
PVISL and NVSL Competitive Winter Indoor League (1st gr. and above). Tryouts will be required for 2017-2018 season. Click here if interested. Separate fee will be assessed if your player is chosen.
Please list what your child needs - entire uniform, socks, shorts, etc.:
Does your child need a new uniform (1st-6th grade ONLY)?:
Yes - $45 charge
PreK-K Clinic Shirt Size:
Home Phone #:
Mother's First Name:
Mother's Cell Phone:
Mother's Email Address:
Father's First Name:
Father's Cell Phone:
Father's Email Address:
Parental Level of Interest/Participation (check all that apply)
By volunteering, you hereby certify that you are 21 years of age or older and that you have never been convicted of a crime or felony in the State of New Jersey, or any other State or territory of the United States of America.
A. HAS YOUR CHILD EVER:
1. Been medically advised not to play any sport?:
2. Experience unconsciousness after an injury?:
3. Had a fracture or a dislocation?:
4. Undergone any surgery?:
B. IS YOUR CHILD:
1. Under a physician's care for a condition?:
2. Taking medication daily?:
C. DOES YOUR CHILD:
1. Have any allergies including hives, asthma, or reaction to bee stings?:
2. Have frequent chest pains or palpitations? :
3. Have a recent history of fatigue and undue tiredness?:
4. Have a history of fainting with exercise? :
5. Wear glasses? Safety sport glasses are required.:
D. DO YOU HAVE:
1. A history of any family members having sudden death under age 65?:
2. Any worries about your child's health, or do you think there may be any reason why he/she cannot participate?:
If you have answered "Yes" to any of the above questions, please explain:
Children must be 4 by 8/1/2017 in order to qualify for the PreK program
I give consent for my child to compete in soccer for the 2017-2018 season.
I waive any claim against the Haworth Soccer Association, its agents, employees, or representatives for injuries said child might sustain while participating in the above-mentioned sport. I understand I am liable for any expenses incurred for injuries connected with participation in sports which are not covered by an insurance policy which is in force at the time of injury. I give my permission for first aid to be rendered in case of accident to my child and also immediate hospitalization if necessary for emergency treatment at the nearest hospital. We are aware that all athletic activity includes the potential for injury. We acknowledge that, even with the best coaching, use of protective equipment and strict observance of rules, injuries are still a possibility. On rare occasions, these injuries can be so severe as to result in total disability, paralysis, or even death. We acknowledge that we have read and understood this warning.
As a parent/ spectator/ coach, I promise to be supportive, positive and orderly in my conduct, to show respect for referees & their decisions and to be courteous to opposing team. I will discuss any problems with the coaches or officials of Haworth Soccer objectively and in private.
After this point, you will be required to use a Visa or Mastercard in order to register. Remember, each child must be registered and paid for separately in order for the credit card payment to go through. Please note that PVISL and NVSL (winter indoor soccer league) is a separate fee. All refunds requested on or before August 31, 2017 will be paid in full minus a $25 processing fee. Refund requests made on or after September 1, 2017 will be 50%. No refunds will be made after September 7, 2017.
It is important to register as early as possible.
Please do not go through to the credit card stage unless you are ready to process payment.
If registration of your child presents a financial hardship, please contact Tae Chang or Greg Kaufman: Haworthsoccer@gmail.com.
Parents, relatives, friends and spectators are encouraged to:
Encourage sportsmanship and fair play
Support the efforts of all the players
Respect the decisions of the referees and coaches
Relax and enjoy the game
Parents and spectators MUST NOT at any time before, during or after any game or activity related to Haworth Soccer Association recreational youth soccer:
Coach (give instruction)
Encroach the field of play at any time for any reason
Enter the field of play at any time for any reason before, during or after any game or activity with the exception of entering or exiting the venue only
Use foul or abusive language
Make comments towards Referees
Make comments towards opposition players
Make comments towards opposition coaches
Make comments towards opposition spectators
Make comments towards own teams coaches/players
Failure to adhere to these simple guidelines will result in the issuance of a warning to the person that the behavior is not condoned by the Haworth Soccer Association and if the behavior occurs a second time during the course of the season the person will be asked to leave the sidelines for the remainder of that season. At the commencement of the following season the person will be allowed on the sidelines but at the first instance of untoward behavior will be asked to leave the sidelines for the rest of that season. Repeated transgressions by any player, parent, family member or friend will result in the player themselves not being allowed to register for recreational youth soccer with the Haworth Soccer Association.
Should you have any questions or problems with coaching or officiating the proper method of communicating your displeasure is to speak firstly to your coach. Your coach will then bring your concerns to the officers and directors of the Association and we will then address your concerns with the appropriate parties.
I accept the code of conduct:
$135.00 - Outdoor (1st Player)
$105.00 - Outdoor (2nd Player)
$105.00 - Outdoor (3rd Player)
$85.00 - PreK-K Clinic (Outdoor/Indoor)
Uniform fee (1st-6th grade ONLY)($45)
Payments Accepted By
: Credit Card information can be entered once this form is submitted