Soccer Registration 2016
Soccer Registration 2016
Travel:
We are pleased to offer competitive, travel soccer for 5th through 8th grades. Practices will be 2
times per week, starting the third week of August. Games will be on Friday and Saturdays,
starting September 9th. If numbers are high, then TRY OUTS may be required. (Registration fees
will be refunded if the athlete doesnt make the team.) 5th and 6th grade athletes will have the
opportunity to play down in the Sr. league only if they do not make the travel team.
RBRA
PO Box 621
Roanoke, IL 61561
Please DO NOT return this registration form to the school.
Board of Directors
Chad Martin, President; Jonathan Weber, Vice-President; Dawn Alford, Treasurer
Dirk Norman; Vince Hummel, Leslie Cargill, Jesse Martin; Brian Reifsteck, Norm Weldon
Birth Date: ____ / ____ / ____ Grade in School this fall: _______
Youth: (6-8)
(10-12)
(14-16)
Adult: (Small)
(Medium)
(Large)
(X-Large)
League
Fee
Childs age/grade
____
Pee Wee
$25
4, 5, or 6 yrs old
____
Jr. League
$30
6, 7, 8, 9 yrs old
____
Sr. League
$40
TRAVEL LEAGUE
$85
COACHES - Volunteers are needed to make this program a success for the kids, please get involved!
Name of Coach: _________________________
Ph#:____________________
______
______
Head Coach - Attend almost all of the practices/games and serve as a contact for the team.
Asst Coach - Attend most of the practices/games and fill in when head coach is not there.
Please pay cash or check payable to RBRA. This registration form and the fee are required prior to participation and
serves as a permission slip for each player to participate in the RBRA baseball program. All participants are
responsible for their own health insurance coverage. In case of an emergency, I give permission for my child to be
given any necessary medical attention by a qualified and licensed medical doctor.
Emergency contact: Name: _______________________ Phone: ____ - ______ or ____ - ______
Parent / Guardian Signature: _____________________ Date: _________ E-mail: ____________________Text