Duchesne City Recreation
             
Duchesne Recreation Soccer
For children between 3-12 years old
Participants must be 3 by April 1st

Early-bird Registration is March 27 - April 10 : $20 without a jersey,$35 with a jersey
Late Registration begins April 10 : $35 without a jersey, $50 with a jersey
All players are required to have a jersey and wear shin guards. Players can wear jerseys from last year and provide their own shin guards or these can be purchased below.
There will be no refunds.

Please Note:Duchesne City sports is now using theMy Duchesne Cityapp for all communications regarding the sports program. The app can be downloaded from your preferred app store.


Soccer teams will practice during the week in Duchesne as determined by the coach.
Games will be played on Saturdays starting at 10 am. Some games may be played in Altamont.

Registration fees cover the use of equipment.
All registrations will be done online at duchesnecity.com and all fees must be paid in full at the time of registration.

If you want a team picture, there will be an extra $15.00 in addition to the registration fee.
Please contact Aubrey Harris at 815-540-1480 for any questions.
Soccer will start the week of April 29 and end the week of June 3.
Registration w/Jersey:   $35.00   Quantity:   Item Subtotal:  
$0.00
Participant's First and Last Name [1]
I am registering for [1]
Gender [1]
Age on April 1st [1]
Jersey Size [1]
Teammate request? [1]

Participant's First and Last Name
[2]
I am registering for [2]
Gender [2]
Age on April 1st [2]
Jersey Size [2]
Teammate request? [2]

Participant's First and Last Name
[3]
I am registering for [3]
Gender [3]
Age on April 1st [3]
Jersey Size [3]
Teammate request? [3]

Participant's First and Last Name
[4]
I am registering for [4]
Gender [4]
Age on April 1st [4]
Jersey Size [4]
Teammate request? [4]

Participant's First and Last Name
[5]
I am registering for [5]
Gender [5]
Age on April 1st [5]
Jersey Size [5]
Teammate request? [5]

Participant's First and Last Name
[6]
I am registering for [6]
Gender [6]
Age on April 1st [6]
Jersey Size [6]
Teammate request? [6]

Participant's First and Last Name
[7]
I am registering for [7]
Gender [7]
Age on April 1st [7]
Jersey Size [7]
Teammate request? [7]

Participant's First and Last Name
[8]
I am registering for [8]
Gender [8]
Age on April 1st [8]
Jersey Size [8]
Teammate request? [8]

Participant's First and Last Name
[9]
I am registering for [9]
Gender [9]
Age on April 1st [9]
Jersey Size [9]
Teammate request? [9]

Participant's First and Last Name
[10]
I am registering for [10]
Gender [10]
Age on April 1st [10]
Jersey Size [10]
Teammate request? [10]
 
Registration w/o Jersey:   $20.00   Quantity:   Item Subtotal:  
$0.00
Participant's Full Name [1]
Registering for [1]
Gender [1]
Age on April 1st [1]
Teammate request? [1]

Participant's Full Name
[2]
Registering for [2]
Gender [2]
Age on April 1st [2]
Teammate request? [2]

Participant's Full Name
[3]
Registering for [3]
Gender [3]
Age on April 1st [3]
Teammate request? [3]

Participant's Full Name
[4]
Registering for [4]
Gender [4]
Age on April 1st [4]
Teammate request? [4]

Participant's Full Name
[5]
Registering for [5]
Gender [5]
Age on April 1st [5]
Teammate request? [5]

Participant's Full Name
[6]
Registering for [6]
Gender [6]
Age on April 1st [6]
Teammate request? [6]

Participant's Full Name
[7]
Registering for [7]
Gender [7]
Age on April 1st [7]
Teammate request? [7]

Participant's Full Name
[8]
Registering for [8]
Gender [8]
Age on April 1st [8]
Teammate request? [8]

Participant's Full Name
[9]
Registering for [9]
Gender [9]
Age on April 1st [9]
Teammate request? [9]

Participant's Full Name
[10]
Registering for [10]
Gender [10]
Age on April 1st [10]
Teammate request? [10]
 
Shin Guards:   $5.00   Quantity:   Item Subtotal:  
$0.00
Socks:   $2.00   Quantity:   Item Subtotal:  
$0.00
Picture(s):   $15.00   Quantity:   Item Subtotal:  
$0.00
Total:
$0.00
Parent/Guardian Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone:
Email:
Please volunteer. You must select the first box.
I understand that the sports programs cannot run without volunteers. Please select any of the following that you can do:
I am willing to Coach.
I am willing to Assistant Coach.
I am willing to be a Team Parent.
In Emergency Notify
Emergency Phone Number
 
Payment Information:
Processing Fee Rates:
Cards:3% plus $0.25 ($1.00 min)
(1.5% surcharge for foreign cards)
eCheck:Free
Method of Payment:
 Update Name from Personal/Organizational Information
Name on Account:
Routing Number:
Account Number:
Institution:
Name on Card:
Account Number:
Expiration Date:
Billing Street Address:
Billing ZIP/Postal Code:
 Change Payment Method
 

Release of Liability/Consent Form:

This consent is for the 2023 season. The participant/s listed above is/are physically fit and otherwise able to participate in this program. I understand the program will be supervised and I further understand Duchesne City Recreation and its employees will not be held liable for any accidental injury incurred while the participant/s listed above is/are participating or while being transported to and from games. I authorize emergency treatment for any accident or illness and consent to allow Duchesne City and its volunteers to use their discretion in administering First Aid medical care to participant/s listed above.

I Agree
I have read and agree to the above disclaimer
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