Soccer – Brown County Parks & Rec

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If you prefer to register in person please print, complete and return
this form to our office .

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Select Activity *

(Age as of July 31, 2019)

Participant's Name *

Age *

Sex *

Grade by Fall 2019

School *

Date of Birth *

mm/dd/yyyy

Years in Program

Parent/Guardian Name *

Mailing Address *

City *

State *

Zip *

Primary Phone *

Alternate Phone

Shirt Size *

IMPORTANT INFORMATION, PLEASE READ!

I would like to HELP: **To Ensure Player Safety a background check will be done on all Coaches and Assistants

Coach

Assistant Coach

Sponsor, Fee -$175.00

Comments or Medical Information

Additional Child

Price

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By participating in this program or event you are granting permission for BCPR to share photos of your child(ren) for promotional purposes.

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Soccer updates

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Youth Soccer

Our soccer program consists of five divisions, ages 3-4, 5-6, 7-8, 9-10 and 11-13.
Registration deadline is in Mid July.
There will be no switching teams after being assigned to one. NO EXCEPTIONS! Games will begin Mid-August and will be played at Deer Run Park.