Fall 2026 Soccer Town of Orleans Youth Commission Signup Form

Fall 2026 Town of Orleans Youth Commission Soccer

Grades 4 to 6
We are currently holding sign ups for fall soccer.

FOR GRADES 4 to 6 ONLY

League is on Sundays in Chaumont with time TBD.
Child Name

First NameLast Name
Current Grade
Date of Birth

MonthDayYear
Age
Gender
Jersey Size
Parent's Name

First NameLast Name
Phone Number

Area CodePhone Number
Text?
Alternate Number

Area CodePhone Number
E-mail
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Medical Conditions or Allergies
I give permission for my son/daughter to receieve emergency medical treatment administered by coaches or Youth Commission Volunteers. In an emergency, if I, the parent or guardian can't be reached, please contact:
Name

First NameLast Name
Phone Number

Area CodePhone Number
Parent/Guardian Signature (by filling out this field you are signing and agreeing to the above

First NameLast Name
I agree to return all equipment/uniforms issued to my child. I understand that I am responsible for repairing or replacing the equipment/uniforms if it is damaged, lost or stolen while in my possession. I understand uniforms are the property of TOYC.
Parent/Guardian Signature (by filling out this field you are signing and agreeing to the above

First NameLast Name
I hereby grant TOYC permission to take and use photographs of my child in any and all of its publications and in any and all other media.
Parent/Guardian Signature (by filling out this field you are signing and agreeing to the above

First NameLast Name
Teams exist with the contingency that a parent or volunteer is willing to accept the coaching challenge.
Additional information / special request
I am willing to help:
Parents/guardians are responsible for providing all required player apparel and equipment, including appropriate footwear, shin guards (if applicable), socks, shorts, and any other required items. The Orleans Youth Commission will provide the official team jersey unless otherwise noted.
Please checkmark the following:
Should be Empty:

Fall 2026 Town of Orleans Youth Commission Soccer