Cost: $65.00 - includes uniform

Fall Soccer games starting September 2, 2025.

Contact: Byhalia Parks and Recreation 662-838-2135 ext. 122

Email: byhaliaparksandrec@townofbyhalia.com

225 MS Hwy 309 Byhalia, MS 38611

Download the Registration Form

Player's Name

First Name

Last Name

Player's Date of Birth

Player's Age Now

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Parent Name

First Name

Last Name

Parent Address if different from above

Phone Number

Which year at selected level?

1st Year

2nd Year

3rd Year

Notes

Shirt Size

Please specify toddler, youth, or adult and the size

Ball Pant Size

Please specify toddler, youth, or adult and the size

Electronic Signature

Date

YYYY

IN CONSIDERATION OF my child/ward, being allowed to participate in any way in the Town of Byhalia/Marshall County Sports related events and activities, the undersigned acknowledges, appreciates, and agrees that: (1) The risk of injury to my child/ward from the activities involved in these programs is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and (2) I FOR MYSELF, SPOUSE, AND CHILD/WARD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child/ward’s participation; and (3) I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child/ward’s readiness for participation and/or in the program itself, I will remove my child/ward from the participation and bring such attention of the nearest official immediately; and (4) I for myself, my spouse, my child/ward, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the Town of Byhalia/Marshall County Sports; its directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my child/ward’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law. (5) for myself, my spouse, my child’s/ward, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my child’s/ward involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.

Parent Name