Youth Soccer Registration Child’s InformationPlease fill out one form per participantName(Required) Grade(Required) Age(Required) Gender(Required) Male Female Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Uniform Size(Required)*A Genola Soccer uniform is required and is charged as a separate fee of $25:Already Have UniformYouth SmallYouth MediumYouth LargeAdult SmallAdult MediumAdult LargeGenola Green Soccer Socks Size(Required)*Soccer socks are required as part of your child’s uniform, you may purchase your own, of any color, or you may choose to order Genola Green Soccer socks now, this is charged as a separate fee of $6.Will Purchase My OwnExtra SmallSmallMediumLargeChoose your child’s grade(Required)PLEASE CHOOSE THE GRADE YOUR CHILD WILL ENTER DURING THE 2024-2025 SCHOOL YEAR. Pre-K and Kindergarten $401st and 2nd Grades $453rd and 4th Grades $505th and 6th Grades $557th and 8th Grades $65Parent/Guardian InformationName(Required) Cell Phone(Required)PhoneEmail(Required) We depend on volunteers to coach, would you be willing to volunteer your time and efforts to coach your child's team this season?(Required) Yes No Please understand if we do not have enough volunteers you may receive a request to coach anyway.Do you have a child 14+ who would be interested in a Referee position for pay? Yes No Initials(Required) **I understand there are risks or injury during recreational sport, I will not hold Genola Recreation, or the coaches, accountable for any injuries that may occur during my child's participation in practices and games. **Parent Signature(Required)Today's Date(Required) MM slash DD slash YYYY Credit Card Processing Fee Price: $0.00 Total Credit CardCard Details Cardholder Name