If you are having trouble registering, send an email to bobd@rysc.org
Player Information - Spring Soccer program
Name: (Last,First)-- Smith, Joe  
Date of Birth: Numbers only in this format! - MM/DD/YY  
Gender:   Male   Female
School Name:  
Grade (in now):  
Parent/Guardian Name:  
Parent/Guardian Phone: (518-555-1212)  
Parent/Guardian Name:  
Parent/Guardian Phone: (518-555-1212)  
Shirt Size:  

 

Please indicate player’s special medical/physical condition(s) only.
If no such condition exists, write NONE.
**Send an email if you have other concerns to: RUSCSSoccer@gmail.com
don't use this area for that. Thank you.

Parent/Guardian Billing Information
First Name:  
Last Name:  
Address:  
 
City:  
State:  
Zip Code:  
Email Address :  
Phone Number: (518-555-1212)  
     
Amount To Charge:  
   
Credit Card (via PayPal)
     
Check
Enter Your Check/MO* #/ Venmo

* If you paying with a MO (money order) and don't have one in your possession at this time, just type 999 in this space.
Please mail payment within 1-2 days of registering and make sure a
PHONE NUMBER is on your payment.
Make your check or money order payable to: RUSC
Mail your payment to: RUSC c/o Bob DiBella
2048 Careleon Road Schenectady, NY 12303
Thank you! 		 
     

I understand that soccer is a contact sport and that although efforts will be made
to provide safe and orderly practice and game conditions, there will always remain
possibility of serious injury. Recognizing that such risks exist, I give my permission
for my child to participate in this activity. I give permission to authorize medical
treatment for my child should the need arise. Also, I give my consent to any
photos taken of my child can be used on the RUSC website for the purpose of
advertising this program.
I agree to the statement above.