Tishomingo County Youth Soccer Registration Form Fall 2026
Age Cutoff as of July 1st
Max Age is 14
Child Name
*
Parent / Guardian Name
*
Phone Number
*
Format: (000) 000-0000.
Email
*
example@example.com
Age Group
*
4-6 years
7-8 years
9-10 years
11 & Up
Shirt Size
*
Youth XS
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Please fill out the information below for each additional sibling playing.
Rows
Name:
Shirt size
Age Group
Additional Sibling 1
Youth XS
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
4-6 Years
7-8 Years
9-10 Years
11 & Up
Additional Sibling 2
Youth XS
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
4-6 Years
7-8 Years
9-10 Years
11 & Up
Additional Sibling 3
Youth XS
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult 2XL
4-6 Years
7-8 Years
9-10 Years
11 & Up
First Child Fee $65
$35 per additional sibling
Total Amount Due:
*
Emergency Contact Name and Number
*
Would you be interested in coaching or assistant coaching?
*
Would you be interested in working in the concession stand or refereeing?
*
Anything else that we might need to know?
How will you be paying registration fees?
*
Online Invoice sent to you
Cash delivered to Iuka Sports Academy in a labeled envelope
Check made out to Iuka Sports Academy
Submit
Should be Empty: