M.A.Y.S.A. Fall 2007 Travel Team Registration
Registration is open to all Mercer Area Youth born between 8/1/89 and 7/31/98.
All registrations will be done through the mail or by contacting the Registrar.
See below for registration requirements. Cost to participate is $40. (make
checks payable to M.A.Y.S.A.)
Uniform: Red MAYSA t-shirt ( $10) , Purchase through MAYSA, see below.
Also blue shorts, red socks, shin guards - you are responsible for purchase.
Teams will be scheduled for 8 Sunday games beginning tentatively 4/01/07, and may participate in a tournament.
REGISTRATION BY MAIL DUE Feb. 23 2007
If you have never participated on a Travel Team please send all of the following:
_____ 1. 1”x1” color picture of player
_____ 2. copy of birth certificate
__X__ 3. Fee - $ 40 ( Checks made payable to M.A.Y.S.A.) $100 family maximum
_____ 4. last 6 digits Social Security #
_____ 5. player pass with player’s signature on
appropriate line. (DO NOT WRITE ANYWHERE ELSE ON PLAYER PASS).
If you have played on a Travel team and are receiving this by mail, send in
the above checked items.
PLEASE RESPOND BY SENDING THIS FORM BY FEBRUARY 23RD.
Mail to: Mara Juergens
345 North Pitt Street
Mercer, PA 16137
Questions: Contact Mara Juergens (662-0727)
maraj@zoominternet.net
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Name ________________________________ Parents Names__________________________
Sex _____ Birth Date _______________________ Grade 06/07________
Address ___________________________________________________________________
Phone# _______________________ email address ________________________________
Do you need a shirt? Y/N______ If yes, SIZE: YL AS AM AL AXL (circle one)
IF YES PLEASE ADD $10 to registration fee
I give my child permission to participate in the activities of the Mercer Area Youth Soccer program. I understand that every precaution will be taken to provide a safe atmosphere, and I will not hold the officers, officials, coaches or players of M.A.Y.S.A. liable in the event of accident or injury. In the unlikely event that medical attention is required for my child, I authorize the calling in of medical personnel and the use of appropriate medication.
Signature ___________________________ (Parent or Guardian)
Amount Paid _______ Check #________ last 6 digits SS#______________________