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1779 Belcher Rd South Largo, fl 33779 In Person Registration

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Serving families in Seminole, Pinellas Park, Clearwater, St. Pete and Largo

Largo United Soccer Club

1779 Belcher Rd South

Largo, FL 33779

In Person Registration at Largo Soccer Complex: Check, Credit Card or Cash

Thursday, March 17th, Monday, March 21st and Tuesday, March 22nd

6:15pm to 7:30pm
Mail application with payment to: Largo United, 13355 Park Blvd, Seminole, Fl 33776.

Make checks payable to LARGO UNITED SOCCER. Applications will not be processed without receipt of full payment.

Email questions to:
Who: Boys and girls of all playing levels ages 4-12. (Players MUST be 4 by April 1st)

What: Spring Soccer Season: A less-formal environment where co-ed teams play in small-sided games every night. It’s a great opportunity to learn skills from our coaches and try those skills in a game. It’s a no-pressure environment with a focus on learning and having fun!

When: (8 Nights) Every Tuesday and Thursday April 5th thru April 28th, 2015.

Time: 6:15pm - 7:15pm

Cost: $75.00

What you get: 2 t-shirts, games and skills sessions by licensed coaches each night, pizza party on the last night

Important: You will receive an email by April 3rd notifying you what team your child is on.

Where: Largo Soccer Complex, located on Belcher Rd., 1 mile North of Ulmerton Rd.

____________________________________Cut here and keep the top half for your information______________________________
Player Name:___________________________________Age__________DOB____________________Circle: Male or Female
Address:________________________________________City:_______________________ Zip:________
Parents Name ________________________________Phone (H) _______________________ (C)_______________________
E-mail(all contact is through email, print legibly):____________________________________________
Select your child’s T-Shirt Size: YS YM YL YXL AS AM AL
How many seasons of soccer has your child played? Has your child played competitive soccer?

Never 1 2 3 4 5 6 Yes No If yes, how long? ________ Where? ___________

I understand that my application will not be processed if full payment is not received at the time of registration. I also understand that my registration fee is non-refundable if my child withdraws within 10 days of the Spring Soccer Season start date. Enclosed is my check for $75.00 made payable to Largo United.

As a parent/guardian of the applicant, I hereby give permission for my child to participate in the LUSC Spring Soccer Session and agree to comply with all program regulations. I hereby release, discharge and otherwise indemnify the soccer fields, city of Largo, staff, management of local organization and LUSC coaching from any liability for injuries incurred during my child’s participation in this program. I, the undersigned parent/guardian, do hereby authorize the athletic trainer or coaches at LUSC or local organization to secure any and all medical treatment in the event that I cannot be contacted. I further authorize any attending physician to render any and all medical care he/she may deem necessary.

Print Name:_________________________________Signature_____________________________________ Date_________________


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