Overbrook Recreation Commission
		2010 SFT Soccer Registration Form
			Return Form and Payment to:
	Overbrook City Hall, 401 Maple, PO Box 288, Overbrook, KS  66524
				Forms Due by 8-21-10
Cost is $25.00 which will include a T-Shirt (Make Check Payable to Overbrook Rec Commission)
			League Teams / Ages
			Year in School for 2010/2011 School Year
			O	Kindergarten - First			Games in all age groups
			O	Second - Third			will be played
			O	Fourth - Fifth			in Overbrook
			O	Sixth - Seventh - Eight			and Lyndon/Osage City
Player's Name  ___________________________					Grade____________		Male  /  Female
Parent/Guardian Name _________________________________						Phone__________________________
Address ______________________________________________						Alt. # __________________________
City/State___________________________				Zip______________		Email __________________________
Drug Allergies ___________________________________________________________________
Medical Concerns (i.e. asthma)  _____________________________________________________
Shirt Size:		YOUTH	Small (6-8)			Adult	Small	XL
			Medium (10-12)				Medium	XXL
			Large (14-16)				Large	XXL
Circle Size needed for Athlete (Please Note Youth and Adult Sizes are available)
Parent Shirts are available for $15.00 a shirt.  Please list sizes Needed_____________________
I would like to help:			________	Coach (which team if multiple kids playing)
			________	Assist in coaching (which team if multiple kids playing)
			________	Referee
			________	Work in Concessions
			________	Help with Field Cleanup Day
Required:  Each player is required to provide their own shin guards and Cleats without a toe cleat
		Parental/Guardian Consent Waiver and Medical Release
I hereby certify that all the information about the aforesaid player is true and correct.  I realize
this soccer program is a not-for-profit and voluntary program instituted for the benefit of children
in the communities.  I therefore, hereby agree to hold no party connected with the team, the sponsors
or the Overbrook Recreation Commission responsible for injury to my child while involved in all
activities with SFT Soccer.  I will be responsible for my child and their actions during all soccer
activities.  If my child is injured, I hereby authorize the coach, or team manager to obtain such medical
attention as my child may need including surgery for emergency situations.  I agree to pay all medical
and hospital charges for my child's treatment.
	Name of Parent/Guardian Printed  __________________________________________________
	Signature of Parent/Guardian  ________________________________Date __________________
Direct Questions to Erick Berckefeldt 665-0203    parksandrec@overbrookks.com