Mighty Islanders Soccer

Registration fee: $55 Island Resident / $60 Non-Island Resident

Deadline: September 10, 2010
No Late Registrations.
Must have your child registered on time and paid before
September 10, 2010 in order to play

You may wish to >> Click and Download forms

Please return Registration form, Waiver form, and payment to:
Stephanie Chipp
19920 Island Parkway E
Lake Tapps, WA 98391

(253) 709-3091

Filling out form below only submits registration email and takes you to a payment screen with Paypal. You will need to download waiver form and submit to Stephanie Chipp.

Player's Name Gender Island Resident

Age: Grade in school: Please note: team assignment will be based on age and grade)

Parent's Name:

Address: City: State: Zip:

(When placing teams we may need to reach you with questions)

Phone: Secondary Phone:

Email:

Interested in Coaching

Interested in Sponsoring

T-Shirt Size (Youth): XS (4-6) S (6-8) M (10-12) L (12-14)

Your child's team will practice one evening per week: Please check ALL days you are available:

Monday Tuesday Wednesday Thursday

Special Requests:

I understand T-Ball / Coach Pitch provide a measure of inherent risk to its participants. I will not hold Tapps Island Association nor coaches and/or volunteers liable for any injury that may occur to my child. I have also read, signed, and turned in the waiver form.
Check if understand above information

You may Download form and print

Please return to:
Stephanie Chipp
19920 Island Parkway E
Lake Tapps, WA 98391