I am 3

Father/Guardian's Name Father/Guardian Work/Cell Phone Father/Guardian Email Address. Has any member of your family participated in an I AM 3RD sport?:
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Important League Dates

General Registration Ends: April 1st Early Bird Price Expired December 31st

Training Locations: Sunday Group

Next Level - 340 Richmond Ave

Monday,Tuesday,Thursday Groups

Lexington Christian Academy - 450 W. Reynolds Road

Training Expectations:

Overall goal of program is to introduce soccer to players, parents and future parent coaches • Each player will training 1 day per week; Sunday, Monday,Tuesday, or Thursday • 6 total training sessions • Each training will be roughly 1 hour and will be very instructional by teaching the soccer fundamentals, group devotional time, drills & scrimmages.

• • • • • •

Training Dates:

April 9/10/12/15 -- Preview Night & receive tee shirt April 16/17/19/22 -- 2nd Training April 23/24/26/29 -- 3rd Training April 30/May 1/3/6 -- 4th Training May 7/8/10/13 -- 5th Training & picture day May 14/15/17/20 -- Last Training

For More Information Contact: I AM 3RD Staff (859) 269.2800 [email protected] Next Level Sports Training Staff (859) 333.4407 [email protected]

Office Use: Reg. # ______ Payment_______ Shorts ______ GR __X__ Staff_____

I am 3

Beginner Soccer Training for 3 year olds! detach along dotted line... detach along dotted line... detach along dotted line... detach along dotted line... detach along dotted line...

Return Registration Form & Fee To: Centenary Church c/o: Recreation 2800 Tates Creek Road Lexington, KY 40502-2806

Registration Information

April 9 - May 20 Available for all boys and girls

Registration Fee: Returning Player (Fall 2017) – $105 ­


New Player – $120

Practice Days: Next Level - Sunday 4:30 | LCA - Monday 5:30 | LCA - Tuesday 5:30 | LCA - Thursday 5:30

*$10 discount for each sibling after 1st child. Includes siblings for 4yrs-8th grade divisions* *Limited Scholarships Available: Must turn in scholarship application with reg. form, before the reg. deadline*

Registration Form Child’s Last Name

Child’s First Name

Gender Child’s Birthdate Please Provide Shirt Size

Home Phone

Street Address City/Zip

School Name

Mother/Guardian’s Name Mother/Guardian Work/Cell Phone Mother/Guardian Email Address Father/Guardian’s Name Father/Guardian Work/Cell Phone Father/Guardian Email Address Has any member of your family participated in an I AM 3RD sport?: ______ If so, please tell us which sport(s)!__________ How did you hear about I AM 3RD Soccer? (flyer, co-worker, social media, neighbor, etc.): _________________________ Are you currently a member/regular attender of a local church? Yes No Which one? ____________________________ * The undersigned understands the particpant may be photographed or videotaped & agrees, without any further right to compensation, to allow such media to be used for use in promoting I AM 3RD the leagues. I AM 3RD leagues are and will remain the owner of the media.

*Please Read Carefully! Release Must Be Signed.*

Medical Release

Doctor’s Name _________________________ Doctor’s Phone ____________________ Does this child have any disabilities, handicaps, present injuries or limitations, including allergies, or any other significant medical condition? _____ If Yes, please state conditions ____________________________________________________________________________________. Emergency Contact (name & phone in the event the parents cannot be reached) ______________________________________ I, ___________________________, parent or legal guardian of ________________________________ do hereby agree and make public that I will not hold Centenary or any adult sponsor responsible for any accidents or injuries that may be susta