St. Mark the Evangelist Catholic Church
Catholic Youth Organization (CYO) Sports Registration Form
Child’s Name: ___________________________________Date of Birth:______________ [ ] Male [ ] FemaleAddress:
___________________________________
City:___________________Zip_________ Current Grade:_____
City of Birth
: ____________________ Age as of
September 1, 2009
:________ Please
check
one of the following: ________ Reside in St. Mark’s CYO Boundaries (see map) ________ Registered Parishioner @ St. Mark: ________ Reside in / or registered parishioner at Holy Trinity or Padre Pio – please circle which parish. ________ Reside in another parish or need a release – Please list parish________________________ Religion:____________________ School Attending:________________________
Father’s Name:
__________________
Home #
______________
Cell / work
#
_______________
Mother’s Name:
__________________
Home #
______________
Cell / work
#
_______________
Father’s Email:
_______________________
Mother’s Email:
___________________________
Will your child be a:
[ ] Returning Player - last year’s coach’s name: _______________________
OR
[ ] New Player I will be using my child’s uniform shirt from last year.
Old Jersey # ___________ {Initial here ______}
New Uniform Shirt Size: (Please circle size)
New Uniform Shorts Size: (Please circle size)
Child:Sm. Md. Lg. Child: Sm. Md.LgAdult: Sm. Md. Lg. XLg. Adult: Sm. Md. Lg. XLg.Parent(s) interested in:
[ ] Head Coach [ ] Assistant Coach [ ] Team Minister [ ] Team Mom [ ] Team Sponsorship
St Mark CYO participation requires parents/guardian to choose one of the following
(
PLEASE READ CAREFULLY
):
a) ____________ Donate time to work concession stand when team has Concession duty day.b) ____________ Pay
$30.00
fee to pay staff to work on your behalf.
Liability Policy: {Initial here _________}
I/We, the parent/guardian of the above named child who has applied for participation in the athletic activitiesof the CYO, hereby give my/our consent and approval to his/her participation in any and all of the CYOand it’s affiliates during the current year. I/We assume all risks and hazards incident to the conduct of such activities, including any and all transportation, and in consideration of the education instructionhe/she will receive in connection therewith. I/We herby agree to release, do by this instrument, release,absolve, indemnity and hold harmless CYO and it’s affiliates, the Archdiocese of San Antonio, and any andall supervisors, organizers, or sponsors of an from any and all liability for any injury to my or foresaidchild, and we waive all claims of any kind against any or all of the organizations or persons hereinaboveenumerated including any and all claims against a person or persons transporting my/our child to/fromany such activities hereinabove named.
Uniform Policy: {Initial here _______}
I/We understand that I/We are responsible for the cost of the uniform for each sport registered. There are no returns onuniforms indicated by wrong size information.
I/We have read, fully understand and agree to comply with the policies stated above.
Parent/Guardian Signature: _____________________________________ Date: ___________________
[ ] Soccer
(Age 4 & up)
[ ] Flag Football
(Ages 4/5, 6/7 & up)
[ ] Volleyball
(Age 7 & up)
Indicate Level of Participation
:Tot 1 (age 4) Tiny 1 (age 6) PeeWee 1 (age 8) Mite 1 (age 10) Cub 1 (age 12) Jr 1 (age 14)Tot 2 (age 5) Tiny 2 (age 7) PeeWee 2 (age 9) Mite 2 (age 11) Cub 2 (age 13) Jr 2 (age 15)
Information below is for the CYO Board Use Only
Registration fee: $65 for 1
st
child, $60 for the 2
nd
child, $55 for the 3
rd
, 4
th
, etc.; City Fee: $12; Uniform Fee: $25Registration Fee: ____________ City Fee: ________ Uniform Fee:_______ Total amount: __________________ Cash or Check #: _________________ Check Amount:__________________
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