Wrestling Lacrosse
Information
HYAA Home Page 		 

HYAA 2016 FALL SOCCER Registration Form

Select League Boys Soccer Girls Soccer
     
Youth's Name
Last
First
     
Address
Holmdel, NJ  07733
Birth Date
Grade (2016-2017)
     
  1. Fitness
    I am personally satisfied as to my youth's fitness to participate in this activity. HYAA strongly recommends that you seek professional medical advice if there is any doubt about your youth's fitness to participate in this activity.

  2. HYAA does not promote, encourage, or guarantee players' requests. We try our best to be sensitive to unique individual circumstances. However, with a program that serves over a thousand children, it is not practical or logistically possible to honor every request. If you have a particular concern other than carpool convenience or playing with friends, please discuss with our administrators at the time of registration.

     
  3. HYAA is a volunteer organization. You must volunteer for one of the assignments below in order for your registration to be complete. Note: Coaches MUST be Rutgers certified and Kid Safe screened. NO EXCEPTIONS.

    1. 2. 3.

     

  4. Emergency Contact
    In Emergency situations you should contact

Father Name 

  

Mother Name 

Primary Phone # 

Secondary Phone # 

Email 

   
Fees
 
Registration Fee
$50 late fee applies after June 19, 2008
 
All Ages $100
  LATE FEE OF $50 WILL BE APPLIED AFTER AUGUST 19    
Sibling Discount First Child
-$0
  Second Child
- $10
  
Each Additional Child

- $15

  
       
Association Fee Once per family, per year (HYAA's year is Sep - Aug)

$25

  
Total Amount Due (3% convenience charge)..............$ 

Submitting this registration form will reserve your child's spot for this season. However, the registration will not be processed until payment is received. PAYMENT FOR ONLINE REGISTRATIONS CAN ONLY BE MADE BY CREDIT CARD. After you click SUBMIT below you will be prompted for your credit card information via our secure payment form.

PLEASE NOTE: HYAA commissioners reserve the right to move players among teams to ensure league balance and fair play.

HYAA is not an affiliate of the Holmdel Board of Education

CODE OF CONDUCT

I understand that ALL parents must sign the HYAA Code of Conduct

Credit card required to submit online registrations

NOTE: All participants will be assigned to leagues on a first come first served basis.

HYAA is not an affiliate of the Holmdel Board of Education