EmailMe Form - Ohio North Soccer - Out of State Permission

*USYSA Rule 201 requires that a youth player register each seasonal year in the State Association in which he/she resides with their parent(s)/guardian(s). A youth player wishing to participate with another team from another state in which they reside must receive written permission from both state associations prior to participation.

This form must be completed by all players requesting permission to play with a state association other than the state in which they reside as well as by any player moving from one state association to another during the Seasonal Year.

Seasonal Year *

A Seasonal Year is September 1st thru August 31st

Player Name *

First Last

Player D.O.B. *

MM / DD / YYYY

Ohio North Member ID

Ohio North Member ID is unique to each registrant. If you do not know, please leave blank.

Gender *

Player Street Address *

Player City *

State *

Player Zip Code *

Guardian Name *

First Last

Guardian Email *

Confirm Email *

Guardian Phone # *

### - ### - ####

Please include the phone number where you can best be reached during Ohio North office hours, 8:30-4 Monday through Friday.

Team Information

Provide information for the team player is requesting to be carded with

Club Name: *

Club Name of the team player will be playing on.

Team Name: *

Team Name player will be playing on.

Age Division *

Age division of the team that the player will be playing on.

Playing League: *

League Name that the team with be playing in.

Accepting State: *

State player wishes to particpate in.
If 'Other' is selected, designate below.

Other State

Only Required if state was not listed in drop down above.

OHIO NORTH PAYMENT

Payment must be sent to Ohio North for the request to be processed. NOTE: Membership with Ohio North needs to be completed annually. The annual seasonal year runs from the fall to the spring (Sept 1 - Aug 31). Players are considered new members at the start of the new seasonal year.

Out of State Permission - $21
(Registration will not be processed without receipt of payment)

Registration/Out of State Fees *

Player Registration $21

Out of State Registration Request will not be processed without receipt of payment.

Payment will be sent via: *

Charge Card through Authorize.net: I will pay with a Credit Card through Authorize.net right now. (please note that after form is submitted, you will automatically be redirected to a payment screen.)

IMPORTANT

Please only hit the "SUBMIT" button once. Multiple clicks can make payments to process multiple times.