» CCC Stars Registration

CCC Stars Registration
Step One for CCC Stars Registration - Complete Form

ALL NEW PLAYERS MUST PRESENT A VALID BIRTH CERTIFICATE PRIOR TO THE ANNOUNCED DEADLINE OR THE PLAYER WILL NOT BE ALLOWED TO PARTICIPATE IN LEAGUE GAMES.
Refunds: Registration refunds due to extenuating circumstances will be given up until the season start date. No refunds after the season begins. By completing this form I certify that all information given is correct. I agree to all stipulations herein and to abide by the rules and regulations of the CCC Stars. I am the parent or legal guardian of the child that I have registered.

For which sport or clinic are you registering?
For Fall Soccer League Click Here. Select below for all other sports.

New or Returning Player?

Jersey Size

Player's Name

Mother's/Father's Name

Date of Birth

Child's Age as of May 1, 2009

Home Address

City

Zip Code

Home Phone

Father's Cell Phone

Mother's Cell Phone

Email Address

Emergency Contact Name (other than parent)

Emergency Contact Home Phone

Emergency Contact Cell Phone

Emergency Contact Work Phone

Emergency Contact Relationship to Player

Please list any allergies/medical problems, including those requiring maintenance medications (i.e. diabetic, asthma, seizure disorder). Include medical diagnosis, medication, dosage, and frequency of dosage.

I/We, the parent(s) of the above named candidate, know that participation in CCC Stars Youth Sports may result in serious injuries. I/we do hereby waive, release, absolve, indemnify, and agree to hold harmless CCC Stars, Cornerstone Community Church, the organizers, sponsors, participants, and persons transporting my/our child to and from activities for any claim arising out of any injury to my/our child, whether the result of negligence or for any other cause, except to the extent and in the amount covered by accident or liability insurance.
I/We Agree

I/We, the parent(s) of the above named candidate, authorize the CCC Stars to publish pictures of my/our child on the local website. Individual pictures or names identifying pictures will not be used.
I/We Agree