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I� <br /> r f <br /> `� WirnlJr 1. <br /> m r <br /> w iof u <br /> 2011 <br /> �/�i u <br /> QUA 34 <br /> R <br /> ---- ----- --------F <br /> a o occer <br /> �i�,�/elf i . 1����; �� a f.>/ � ✓ 1 ��i , <br /> Roseville Parks les time to plan ahead and register for Fall Soccer! <br /> and Recreation > Fall Youth Soccer is o)en to girls an <br /> boys grades K through h six g <br /> 651-792-7110 > Teams are coordinated and led by volunteer coaches <br /> Register online @: > Practice held at neighborhood parks on week nights,games scheduled on Saturdays, <br /> wvwv.cityofroseville.com/ beginning Saturday, September 10th <br /> parks > Practices begin the week of August 29 <br /> Fax Registration > Everyone participating receives team shirt <br /> 651-792-7100 > All players must wear shin guards <br /> Program size and registration Emits are based on the response from volunteers. <br /> Grade is grade going into this fad. Registration deadline July 29M Fees through July 29: <br /> Regular $50, Roseville Resident $42 Registration after July 29 will only be accepted if there is space <br /> available and fees will be Regular $60, Roseville Resident $52. <br /> volunteer coaches are needed to work with teams in each age group! <br /> Children of volunteer coaches receive 50% discount of soccer registration fees. <br /> For information and a coachig application, call 651-792-7006 by July 16. <br /> Tennessen Warning: The information requested on registration form will be used to verify eligibility and determine staff, <br /> facility, and equipment needs.Your name, address, &telephone number will be provided to the city staff,volunteers,the city <br /> attorney,insurer and auditor. Although you are not legally required to disclose this information,failure to do so will prevent you <br /> from participating in the program. <br /> Youth Fall Soccer Registration - Roseville Parks & Recreation - 2660 Civic Center Dr. - Roseville, MN 55113 <br /> Please fill out form co-in pl e tel y Players Date of Birth-------------------------- <br /> Yes, I would be interested in coaching my child's team: I Email <br /> Name Parent Name <br /> Home Phone Parent Work Phone <br /> Address City Gip <br /> School Place on team with (one name only) <br /> Coed K —(#2350 . 361) <br /> Coed 1-2 (#2350 . 362) <br /> Coed 3-4 (#2350 . 3 6 3) Method of m <br /> Pa ent: Cash Check Visa MasterCard <br /> Girls 3-4 (#2350 . 36 4) Y <br /> Coed 5-6 #2 3 5 0 . 3 6 5) Account Number <br /> Girls 5-6 #2350 . 366 ) Expiration Date Fee Enclosed <br /> Name on Credit Card <br /> Signature <br />