1. sports
2. soccer

Caroline Soccer Program Fall 2014
School has begun and we're getting ready for another great season of soccer!
Soccer at Caroline is a fun, non-competitive, co-educational and skill development based
program. It’s a wonderful way to get to know other students and their families while
strengthening our community!
Paul Rhudy will again be coordinating the Caroline Soccer Program. If you have any questions or need
assistance, please don’t hesitate to contact Paul at 273.7125 or 279.9949, or email him at
prhudy@liberty-resources.org.
Registration and Schedule:
Please send in completed registration and emergency medical care forms (attached
pages) with your child to school AS SOON AS POSSIBLE. The deadline for registration
is Tuesday September 9th, 2014. A practice/scrimmage will be held at Caroline Elementary
Fields on Saturday September, 13th, 1pm, for all teams. This will be the first chance for players and
coaches to meet one another and practice/scrimmage. Practices will begin the week of Sept. 15th at
Caroline during the week in the early evening hours. All games will be played on Sundays at 1:00, 1:30
or 2:00 pm and this year will be held on: Sept. 21, Sept. 28, Oct. 5, Oct. 12, Oct. 19, and Oct. 26,
2014. Plan for one practice and one game a week. Games canceled due to bad weather will be
rescheduled by the coaches and teams involved.
Equipment:
Shin guards are mandatory for all games and practice sessions. BALL: (recommended) K/1 & 2/3 -- size
3 soccer ball, 4/5 -- size 4 soccer ball. CSA has balls for practice and games. Sneakers and soccer cleats
are acceptable footwear. Included in the cost of the program is a soccer shirt for your child. Please
have them wear these to all games.
Cost:
The program fee is $20.00. The fee covers the program expenses (shirts, referees, equipment, field lining,
copying, porta-john etc.). Anyone who wants to play can. The program is open to all youth of elementary
age who reside in the Caroline school area. If your family needs a scholarship, please check the
appropriate place on the registration form. Donations to the scholarship fund are appreciated.
Volunteers / Information:
The soccer program is possible due to parent and teacher volunteers. If you have the time, interest and
like to have fun, please consider contacting us and helping coach or co-coach a team. No prior
experience or knowledge is necessary. Teams are designated by age/skill level (K-1, 2-3 and 4-5). If you
have questions or need additional information, contact Paul Rhudy, 273.7123/279.9949 or
prhudy@liberty-resources.org. Paul is happy to attend practices and provide guidance.
COACHES MEETING Thursday SEPTEMBER 11th - 6:00 PM at the shed near the soccer fields.
Caroline Soccer - Fall 2014
Registration Form
Registration:
Please return this form to the Caroline Elementary School Office in an envelope marked
"Caroline Soccer." Deadline for registration is Tuesday September 9th.
Player's Name: _____________________________________________
Grade: _________
Parent/s or Guardian/s: _______________________________________ Teacher: __________________
Mailing Address: ___________________________________________
___________________________________________
Phone Number: __________________________
E-mail address: _____________________________________
Siblings Playing & Grade: ____________
Shirt Size: YM, YL, AS,
AM, AL
Town of: __________________ (we need this for administrative purposes)
The program coordinators and coaches will be assigning the teams based on grade level, seasons of
soccer experience and skills. Players will be contacted by the program coordinators or their coaches as
the teams are confirmed. Considerations? __________________________________________________
____________________________________________________________________________________
Fees:
Program Fee ($20.00): ______________________ (shirt will be provided)
Scholarship Donation (Optional): ______________
Total Amount Enclosed: _____________________
Scholarship needed: y / n (Circle)
Please make checks payable to "Caroline Sports Association, Inc."
**********************************************************************************
Volunteers:
The Soccer program is possible because of active parent involvement. Please help if you
can by listing your name and phone number on a line below. Thank you.
Coach: ____________________________ (phone) _______________Grade Level: _______
Assistant Coach: ____________________ (phone) _______________Grade Level: _______
Best Practice night (s): ___________________________________
COACHES MEETING Thursday September 11th-6:00 PM at the shed near the soccer fields.
First Aid: ________________________________________ (phone) ______________
Administration: __________________________________ (phone) _______________
E-mail address: ______________________________________
Caroline Soccer - Fall 2014
Emergency Medical Care Form
Player's Name: ________________________________________________ Grade: ______________
Address: ____________________________________________________________________________
Parent/s or Guardian/s: _______________________________________________________________
Cell # ____________________________
Cell # ________________________________
Parent email: ________________________________________________________________________
This form allows parents and guardians to authorize the provision of emergency medical treatment for
children who become ill or injured when parents or guardians cannot be reached.
If attempts to contact me at my home phone _____________________, my work phone
__________________, or cell phone (above) have been unsuccessful, I hereby give consent for the
administration of any treatment deemed necessary by:
________________________________________(physician) at _________________(phone)
________________________________________(dentist) at ___________________(phone)
If the designated practitioners are not available, I give permission for my child to be treated by another
licensed physician or dentist. If I cannot be reached during an emergency, please contact:
Name: ________________________________________________
Relationship: ___________________________________________
Phone: ____________________________ Cell # ______________________________
This authorization does not cover major surgery unless the opinions of two other licensed physicians
concurring in the necessity for such treatment are obtained prior to surgery. Facts concerning the child's
medical history, medication, allergies and physical impairments to which a physician should be alerted
are
_____________________________________________________________________________________________________
_____________________________________________________________________________________________________
Signature of Parent/s or Guardian/s:
_____________________________________________________________________
_________________________________________________________
Date: ____________
Date: _______________
Permission:
I give my permission for my child to participate in the Caroline Youth Soccer Program sponsored by the
Caroline Community Sports Commission. We acknowledge that participation in this soccer program
entails risks and dangers. I understand there is no supplemental accident insurance coverage provided for
participants in the program. We also understand that the presence of qualified instructors does not relieve
participants of the responsibility for their own safety. We agree to exercise caution and good judgment
throughout the program. Furthermore, I verify that my child has been checked by a licensed physician
and is physically able to participate in this program.
Signature of Parent/s or Guardian/s (required):
________________________________________________________
________________________________________________________
Date: _____________
Date: _____________