Fall 2022 Soccer Registration

Fall 2022 Youth Soccer Registration Form

All players must upload a photo every fall season. (cropped to head shot)

If player did not play for SAI in the most recent season (Spring 2022), you will need to upload a Birth Certificate (picture image or PDF)
Current Playing Ages (Fall 2022 & Spring 2023)
Age divisions work much like a school year, they advance one age group every fall season.

U6                                                U11/12
2019, 2018, 2017                        2012, 2011

U7/8                                            U13/14/15
2016, 2015                                  2010, 2009, 2008

U9/10                                         Girls HS (Fall), Boys HS (Spring)
2014, 2013                                 2007, 2006, 2005, 2004

Note: We provide T-shirts for U6 division only (included).
Uniform cost is not included in the registration fee. This will be paid to your coach separately.

Players will need cleats, shin guards and the correct size ball for their age division.
U6-U8 Size 3, U9-U12 Size 4, U13+ Size 5
Shin guards are absolutely required for games. Sock must be on the outside and completely cover the shin guard.
Player
Player Name *

First Name Last Name
Date of Birth *

Month Day Year
Date MM/DD/YYYY
Male/Female *

M F
Shirt Size (if U6) *
School District *
Current ISD School *
If not yet in school, enter elementary school they will attend or area you live in.
ISD High School the player will attend *
Current Fort Osage School *
If not yet in school, enter elementary school they will attend or area you live in.
Current Blue Springs School *
If not yet in school, enter elementary school they will attend or area you live in.
Other School District
Current School *

Requests

Requests are not guaranteed and are based on availability. We will do our best!
Was this player rostered on an SAI team in Spring 2022?

Yes No
Spring 2022 Team
Select your team from SPRING, even if you do not wish to return to this team (see next question)
Do you wish to return to this team? (as long as your player is still age eligible)

Yes, return to same team No, please place on a different team
Team Request
Not Required
Teammate Request
Not Required
Coach Request
Not Required

Contact Information
Player Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Primary Contact_____________________________________
Primary Phone Number *
Primary E-mail *
example@example.com
Primary Contact Name *
First & Last
Relationship to Player *
Additional Contact___________________________________
Additional Phone Number
Additional E-mail
example@example.com
Additional Contact Name
First & Last
Relationship to Player

Experience & Expectations

Many things are considered in team placement. When multiple options are available we look at all factors. Occasionally there may only be one team available for your age, however if there is a variety of developmental levels, the following can help guide us with what you are looking for out of your soccer experience.
Experience with Organized Soccer *

None Less than a year 1 -2 years 3 - 4 years 5 years or more
Expectations *

Brand New To Soccer, First Experience Looking For Fun Activity & Making Friends Played Before & Just Enjoy the Game Experienced, Looking for More Advanced Development

Siblings
Does this child have siblings that will play with SAI this season? *

Yes No
Sibling Info: Name, Birth Year & Team Name/Coach if known
Name, birth year, team (if known)

Practices

Teams practice on weeknights. Frequency, location and time will be up to the coach. If the situation allows, we will try to accommodate any weeknight practice conflicts.
Are there any days of the week that would absolutely prevent your child from participating. *

Yes No
Select a day ONLY if it means there is no way possible for your child to practice on that evening and it would prevent them from playing this season.
Comments

Anything else we would need to know or special circumstances that apply?
Comments

Coaching

All of our coaches are volunteers. We often have to recruit new coaches each season to be able to accommodate all registrations and give everyone the opportunity to play.
Perks of being Head Coach
- 1 free player per head coach
- Control your family schedule - Coach chooses day, time, frequency & location of practice
- Avoid weekend conflicts - Coach submits conflict requests for games
- Choose your team name
- Choose your team color (and uniform if U7+)
- Opportunity to be an influencial role model for youth
Please select one of the following: *

Already a coach. Interested in being a head coach if needed. Interested in being an assistant coach. Friend or Other Family Member might be interested. Not really interested but contact me if absolutely necessary. No thanks, no one in my family could do this.

Documents/Uploads

All players are required to submit a copy of their birth certificate and a picture for their player card every year. We do this in the fall for all players, or spring if they did not play in the previous fall session.
Birth Certificate Upload *

Browse Files
Official State Issued BC only. Picture or pdf is acceptable, make sure all info is visible. Cancel of
Picture (Head Shot) *

Browse Files
Make sure the picture is of the player only and cropped to shoulders up. Cancel of
Reduced Rate

Documentation must be uploaded and received with this registration to qualify. Only 1 of the following is needed.
Check any that apply (If checked, must upload verification in next step)

This child or older school aged siblings of this child in the same home receive free or reduced lunch at school. This child has a MO Health Net Or Medicaid insurance card with their name on it. Parent has an EBT card.
Reduced Rate Verification (Optional)

Browse Files
Upload copy of free/reduced lunch status, medicaid card or EBT card. Only 1 needed. Cancel of

Emergency Contact

Please provide 1 emergency contact OTHER than the parent/guardian or contact previously listed.
Emergency Contact (Not Parent or Previously Listed) *

First Name Last Name
Relationship *
Phone Number *
Release/Signature
Liability Release

I, the parent or legal guardian of this player, a minor, agree that I and the player will abide by the rules and regulations of the United States Sports Specialty Association. I, for myself and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the (USSSA) the owners and operators of the facilities used for the Programs, and their respective directors, officers, employees, agents and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player's participation in the programs including, without limitation, player's transportation to/from any program, which transportation is hereby authorized. I future grant USSSA and Soccer Association of Independence, the right to use the player's name, picture and/or likeness in printed broadcast and other material concerning the Programs provided such use is related to the player's status as a participant in the Program.
I have read and agree to the above conditions *

Yes
Earrings

Persuant with Law 4 of the FIFA Laws of the Game (below), I understand that earrings (or any pierced jewelry) are NOT allowed in the game of soccer. Earrings and other jewelry MUST be removed for the duration of the game in order to participate. This includes recent piercings. Bandaids, tape or other remedies of protection will not be allowed.

“A player must not use equipment or wear anything that is dangerous [to themselves or to other players]. All items of jewelry (necklaces, rings, bracelets, earrings, leather bands, rubber bands, etc.) are forbidden and must be removed. Using tape to cover jewelry is not permitted. The players must be inspected before the start of the match and substitutes before they enter the field of play. If a player is wearing or using unauthorized/dangerous equipment or jewelry the referee must order the player to: remove the item, leave the field of play at the next stoppage if the player is unable or unwilling to comply."
I have read and agree to the above conditions *

Yes
The following are prohibited from any soccer fields, including games and practices, and will result in being asked to remove these things from the playing area, or in some cases from the facility.

No Pets

No Smoking/Vaping/Tobacco Products/E-Cigs

No Alcohol

No Firearms
I have read and agree to the above conditions *

Yes
Parent Behavior & Expectations

I understand that as a spectator, a referee may stop the game, or I can be asked to leave the park, if my behavior is not positive and respectful to coaches, refs, players, other spectators or league officials. My refusal to cooperate may result in a forced forfeit for the team.
I have read and agree to the above conditions *

Yes
Confirmation E-mail *
example@example.com
Signature

Clear
Electronic Signature
Person Completing This Form

Payment
Transactions must be separate, one per child/form.

Registration Fee - Select ONLY one *

Regular Registration $ 75.00

Reduced Rate (I uploaded verification of qualifying documents) $ 50.00

3rd Child - This is my 3rd child (or more) registering this season, I have already paid the regular fee for 2 children. $ 15.00

Coach's Choice (I am head coach and this is my coach's choice) Free

Enter coupon

Total $ 0.00

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Should be Empty:

Player

Requests

Contact Information

Experience & Expectations

Siblings

Practices

Comments

Coaching

Documents/Uploads

Reduced Rate

Emergency Contact

Release/Signature

Payment

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