Clone of Spring 2026 PCYSA

PCYSA Soccer Registration

Fall 2026
You will need to fill out one registration per child. At the end of the registration form you will be taken to our payment portal. Once you have completed the registration and payment you can start a new registration form for the next child.All online registrations must include payment.
2026 FALL SEASON: AUGUST 15 THROUGH OCTOBER 3

DEADLINE FOR REGISTRATION: JULY, 16, 2026

**NO LATE REGISTRATION, NO REFUNDS, NO SPECIAL REQUESTS**
Player Information:
Player Name

First NameLast Name
Player Birth Date

MonthDayYear
Player Male/Female
Player League 2025/2026:
Experience level(number of previous seasons played)
Medical Conditions or Prohibitions:
Medication Allergies:
Food or Drink Allergies:
Sibling in the Same League(same team)?
If yes, Sibling's name:
UNIFORM INFORMATION

Players are required to have appropriate Soccer cleats(no toe cleats), black shorts, shin guards, and soccer socks(must cover shin guards) to be eligible to play. Registration fee includes player shirt and insurance.
Player 1 Shirt Size
PARENT/GUARDIAN INFORMATION:
Parent/Guardian Name

First NameLast Name
Additional Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
E-mail
Volunteer Opportunities

Please consider supporting PCYSA by being a volunteer. PCYSA operates entirely by volunteers and we need your support!
Would you volunteer to be a coach?
Name of Volunteer Coach: Name .
Phone NumberPhone Number .
Coach Shirt Size. If you selected yes to coaching, please select your shirt size.
Would you volunteer to be a Board Member?
Name of Board Member: Name .
Phone NumberPhone Number .
Board Member Shirt Size.
Referee Opportunities

Referees are paid positions. We greatly need referees in order to have fun and fair games. Let us know if you are interested in being a referee. Interested parties must be at least 12. Adult referees are welcome, especially for the Jr/Sr games.
Would you like to know more about becoming a Referee?
Name of person interested in being a referee : Name .
Phone NumberPhone number .
Consent and Waiver
By submitting the form, I, as the parent/guardian of the registrant, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may given under whatever conditions are necessary to preserve the life, limb, or well-being of registrant.
By submitting this form, I as parent/guardian of the registrant hereby waive any right and all rights and claims against PCYSA, its Board of Directors, Commissioner, Chairpersons, Referees and/or Coaches arising in or out of participation in PCYSA’s soccer program. I do further agree to hold PCYSA harmless for any liability whatsoever arising from injuries suffered by the person registered above while a participant in the PCYSA soccer program. I give permission for pictures of my child to be used to promote PCYSA.
Understanding: I understand that the PCYSA, its Board of Directors, Commissioner, Chairpersons, Referees and/or Coaches do not offer special requests and/or refunds. Also, I understand that rescheduling of canceled games is not guaranteed.
Signature
Print Name
Printed Name
REGISTRATION PAYMENT

DEADLINE FOR REGISTRATION is JULY 16, 2026.**NO LATE REGISTRATION, NO REFUNDS, NO SPECIAL REQUESTS**
2026 FALL SEASON: AUGUST 15 THROUGH OCTOBER 3

DEADLINE FOR REGISTRATION: JULY, 16, 2026

**NO LATE REGISTRATION, NO REFUNDS, NO SPECIAL REQUESTS**
Families with multiple children enrolled receive $5 discount for each child

Enter coupon code SIBLING for discount for multiple players.

Your child must be 3 years old by August 1, 2026 to register.
Please make selection below to complete payment and registration. Online registration includes surcharge for processing. The links below will take you to PayPal site to complete your payment. PCYSA is a PayPal Verified merchant. You may pay by credit card or PayPal account. Online Registration must include payment via PayPal. Any registration without payment will not be accepted. Alternatively, you may print completed form and mail with payment to

PCYSA

PO Box 21

Rockville, Indiana 47872
Browse Files

Cancelof

Online Registration includes processing surcharge

Soccer Registration - Kindergarten and Up$51.50

Soccer Registration - Preschool$41.50

Preschool players must be 3 by August 1, 2026.

Enter coupon

Total $0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Should be Empty:

PCYSA Soccer Registration

Player Information:

UNIFORM INFORMATION

PARENT/GUARDIAN INFORMATION:

Volunteer Opportunities

Referee Opportunities

Consent and Waiver

REGISTRATION PAYMENT

Online Registration includes processing surcharge*

Payment Methods

Online Registration includes processing surcharge