PEMAA Soccer 2025 - U12 (Point Edward Minor Athletic Association)

PEMAA Soccer 2025 - U12

PEMAA Soccer registration for the summer of 2025 (May 5 to Aug 1). Please note this is a co-ed soccer program. If there is an "*" (Asterix) beside the question, that means the field is mandatory. If you are using a phone to fill out the registration, it is best viewed in Landscape vs Portrait.

U12 team (2014\2015) - Registration

*Point Residents, Coaches and Sponsors for advanced priority only at this time please. Open registration will start on Feb 4.

Registration:^*

Required

Are you a Point Edward Resident, Coach or sponsor or Non-Resident?

Player Information:

Please fill out the player information:

Surname:^*

Required

Players Surname:

Name:^*

Required

Players Given Name:

Name2:

Players Middle Name:

DOB:^*

Required

Players Date of Birth:

Gender:^*

Required

Players Gender designation - Point Edward Soccer is a co-ed sport.

previously provided proof of Point Edward residency

Yes
No - Please provide proof of residency (Picture of driver’s license or utility bill, etc.).

Have you previously provided proof of Point Edward residency?

Players Prof of Pt. Edward residency

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf.
Maximum # Files: 1. Maximum File Size: 4MB.

Please attach a picture of your players proof of residency if you live in Point Edward? if you getr an error the file is too large, take a screenshot of your picture and try submitting the screenshot picture.

Address:

Please fill out the full address of the player.

Street:^*

Required

ex.: 123 Abcd Drive

City:^*

Required

Postal Code:^*

Required

ex.: N7S8G2

Primary Parent Contact:

Please fill out the Primary contact for your player.

Parent1:^*

Required

Primary Parent Full Name:

Email1:^*

Required

Primary Parent Email Address: [email protected]

Phone#1:^*

Required

Primary Parent Phone #: ex. - 5553945555

Alternate Parent Contact:

Alternate parent contact

Parent2:^*

Required

Alternate Parent Full Name:

Email2:^*

Required

Alternate Parent Email Address: [email protected]

Phone#2:^*

Required

Alternate Parent Phone #: ex. - 5553945555

Blended Family Contact

Add blended family contact information here:

Name#3:

Blended Family full name:

Email#3:

Blended family email address: [email protected]

Phone#3:

Blended family contact Phone #: ex. - 5553945555

Registration Information:

Please fill out the Soccer information section. **All players must wear shin guards during play.

U12 Team:^*

U12 Team

Check the box to verify you are registering for the U12 team. If you need to register for a different team, please go to our website and click on the correct registration link.

Ability:^*

Required

What is your players soccer ability?

Shirt:^*

Required

Players shirt size? << Youth size chart: https://pointminor.ca/Public/Documents/2022/Soccer/Y350.pdf >> Adult size chart: https://pointminor.ca/Public/Documents/2022/Soccer/A350.pdf

Photos?:^*

NoYes

Required

Do we have permission to Photograph your player for postings on our Website or Facebook, Etc.?

Request

Sibling or friend request - *we will do our best to honour ONE request – must be in the same division

Payment Information:

Payment of $125.00 can now be made via E-Transfer to: [email protected]

Payment:^*

Required

How will you pay for this season's registration? * if paying by EFT, please include your player(s) name's in the comments of the EFT.

Confirmation:^*

Required

Email Address to send confirmation of this registration form: Example: [email protected]. Your submission will be sent to this address. Email confirmations may take time to get to your inbox. *Please verify your email address is correct! Check Junk Mail if you do not see the response in your inbox.

Coaching:

Would you be interested in Coaching or being a part of the coaching staff? Only fill out this section if you are planning to coach or be a part of the coaching staff:

Coaching?:^*

YesNo

Would you be interested in coaching a team? Only fill out the below questions in this section if you want to coach or be on the coaching staff of a soccer team.

Coach:

Full Name of the volunteer to coach a soccer team.

Position:

What is your primary pick for a position on the team? Head Coach or Assistant Coach?

Division:

U5- Mite (2020\2021)
U8 - Hot Shots (2018\2019\2020)
U10 - Tyke (2016\2017)
U12 - Junior (2014\2015)

What division(s) are you applying to coach?

Experience?:

Do you have experience?

Shirt:

Coach's shirt size? - Adult size chart: https://pointminor.ca/Public/Documents/2022/Soccer/A350.pdf

Sponsorship section?:

Interested in Sponsoring a team? Please only fill out this section if you plan on sponsoring a team. (Note: Colour choices are for sponsors only)

Sponsor:^*

Yes
No
Need more information first.

Required

Would you like to sponsor a team? - Only fill out this section if you want to sponsor a soccer team.

Sponsor Name?:

What is the name of the sponsor?

Payment:

How will you pay for the sponsorship? The cost to sponsor a team is $300.00 for one team and $500.00 for two teams. * If paying by EFT, please include your company name in the comments of the EFT.

Colour1:

As a sponsor, what is your first colour choice for the shirt of the team you will sponsor?

Colour2:

What alternate colour choice for the shirt for the team you sponsor?

Division:

U5- Mite (2020\2021)
U8 - Hot Shots (2018\2019\2020)
U10 - Tyke (2016\2017)
U12 - Junior (2014\2015)

What division(s) do you want to sponsor?

Logo:

Allowed extensions: .jpeg, .jpg, .png, gif, .pdf, .doc, .docx.
Maximum # Files: 2. Maximum File Size: 4MB.

Please upload your logo to be used on our website on the soccer sponsors page.

# of teams

One TeamTwo Teams

How many teams do you want to sponsor? * The cost is $300 per team or $500 for two teams

Player Code of Conduct:

ü Learn the rules of the game.

ü Treat teammates, coaches, referees, and others with RESPECT.

ü Respect the judgment of the official(s), even if you disagree with their judgment.

ü Play for the fun of it.

ü Control your temper. Not only against the opposing team and officials, but with yourself and your teammates.

ü Do not use foul or inappropriate language at any time.

I agree to the terms and conditions stated above^*

Parent Code of Conduct:

As a Point Edward Soccer Club parent:

I shall….
• Encourage and support my child’s experience and play on the field
• Encourage good sportsmanship and self-discipline to my child and teammates through example
• Support the coach and the team
• Respect officials and accept their decisions
• Familiarize myself with the rules of the game
• Comply with rules, policies, and procedures of the team and the club
• Forward any concerns in writing to [email protected]

Further I will never…

• Engage in dissent directed to an official
• Engage in any kind of unsportsmanlike conduct with coach, player, parent, or any official
• Coach from the sidelines
• Disrespect opposing team players
• Interfere at any time with the duties and responsibilities of the coach
• Act in any way that is detrimental to the team or the Point Edward Soccer Club

I agree to the terms and conditions stated above^*

CAREGIVER AGREEMENT:

I hereby declare that I am willing to allow my son/daughter to participate in playing soccer. My child/ward is participating voluntarily in these activities, events and programs. I agree there are risks involved in soccer as outlined above. By participating voluntarily in these events and activities, my child will be exposed to risk and hazards. I agree to accept the risks and hazards and be responsible for any injury or other loss which he/she might incur while participating in Point Edward Soccer.

I (we) hereby release the Point Edward Minor Athletic Association soccer organizers from all manner of action, cause of action, claims or demands which may arise from my child/ward participating. In this agreement, I understand “organizers” to mean: The Point Edward Minor Athletic Association Soccer Club, it’s Directors, Officers, Members, employees, volunteers, official’s participants, clubs, agents, sponsors, owners/operators of facilities and representatives.

I acknowledge by registering my child/ward to play soccer, I have read and agreed to the above.

I agree to the terms and conditions stated above^*

Point Edward Minor Athletic Association Waiver and Release of Liability

All Programs and Activities Have Their Risks

My child/ward will participate in the game of soccer because it is physically and mentally challenging. In consideration of my child/ward’s participation in such programs, activities and events, I hereby acknowledge that I am aware of the risks and hazards associated with or related to this activity. The risks and hazards include but are not limited to:

· Injuries from executing strenuous and demanding physical techniques in soccer

· Injuries from grass, turf and other surfaces including bacterial infections and rashes

· Injuries resulting from falls to the ground due to uneven or irregular terrain or surfaces

· Injuries from collisions with walls and soccer equipment

· Injuries resulting from failure to properly use any piece of equipment of from the mechanical failure of any piece of equipment

· Spinal cord injuries which may render one permanently paralyzed

· Injuries from extreme weather conditions which may result in heat stroke, sunstroke or hypothermia

· Injuries from contact, colliding or being struck by other participants, spectators, equipment or vehicles

· Injuries resulting from vigorous physical exertion and strenuous cardiovascular workouts

· Injuries from exerting and stretching various muscle groups

· Travel to and from non-competitive events which are an integral part of the organization’s activities.

Furthermore, I am aware:

· That injuries sustained in soccer can be severe

· That my child/ward may experience anxiety while challenging themselves during activities

· That my child/ward may come into close contact with other participants including the possibility of accidental and unexpected contact, this includes possible exposure to COVID 19 virus

· That my child/ward’s risk of injury is reduced if I follow all rules established for participation

· That my child/ward’s risk of injury increases as he/she becomes fatigued

I agree to the terms and conditions stated above^*

PEMAA Soccer 2025 - U12 (Point Edward Minor Athletic Association)

OMHA Digital Network

U12 team (2014\2015) - Registration

Player Information:

Address:

Primary Parent Contact:

Alternate Parent Contact:

Blended Family Contact

Registration Information:

Payment Information:

Coaching:

Sponsorship section?:

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