2026 Fall Soccer Registration Form
Deadline for registration is August 9th. We anticipate the season running through the end of October. All communication from the Recreation Department will be done via email. Registration fee is $35 for 1st - 8th grade and $25 for Micro (Age 3 - Grade K).
Youth's Name
*
First Name
Last Name
Grade or Age (2025-2026 School Year)
*
Pre-K or not enrolled
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Age
*
Shirt Size (Youth)
*
Youth XS
Youth S
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Parent/Guardian Contact
*
First Name
Last Name
Email
*
example@example.com
Phone Number (Cell preferred)
*
Please enter a valid phone number.
Format: (000) 000-0000.
Secondary Phone Number (Optional)
Please enter a valid phone number.
Format: (000) 000-0000.
If you would like to coach or volunteer, please select which options you would be willing to do.
*
Head Coach
Asst. Coach
None
Comments / Requests / Notes
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Waiver and Release of Liability
By agreeing to the terms & conditions below, you agree to the Player & Parent Agreement Statement as follows. "I, the participant, or my child named above agree to participate in the Page County Recreation Leagues or Activities. I hereby release any and all rights and claims for damages I may have against anyone associated with the Page County Recreation Leagues or Activities, or any other group or organization in whose building or grounds this activity is being held, and instructors or persons of these groups for injuries received in participating in any sponsored activity. I also agree to abide by any and all rules and regulations set forth by the Page County Recreation Leagues and Activities."
Do you grant permission for the Page County Recreation Department to use photos that may include your child for promotional purposes? (For Example: Social media posts, program booklet, newspapers, etc)
*
Yes
No
Signature
*
Submit
Should be Empty: