St. Madeleine Sophie CYO registration is open to parishioner and parish school children. After your registration is complete, you will receive a call or email from your coach about practice and game dates and times.
Sport: Select Cross Country - $20 all grades Soccer - $20 Kindergarten Basketball - $65 1st Child Basketball- $55 2nd Child Basketball - $45 3rd Child
First Name: Last Name:
Birthdate: Grade: Select Pre-K K 1 2 3 4 5 6 7 8 Gender: Select Female Male
Special needs or additional comments
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Parent(s) or Legal Guardian(s) Name:
Parent(s) or Legal Guardian(s) Email:
Parent(s) or Legal Guardian(s) Cell Phone: Home Phone:
Parent(s) or Legal Guardian(s) Address:
Parent(s) or Legal Guardian(s) City, Zip:
All consent information is required.
* Yes, I/we the parent(s) or legal guardians of the named student(s) hereby give my/our permission to participate in any and all of the activities of St. Madeleine Sophie Parish CYO during the 2012-2013 Season.
* Yes, I/we do further release, absolve, indemnify and hold harmless St. Madeleine Sophie Parish, the organizers, sponsors, supervisors and coaches of the St. Madeleine Sophie Parish CYO program, any and all of them.
* Yes, in case of injury to my/our child, I/we waive all claims against the organizers, the sponsors or any of the supervisors appointed by St. Madeleine Sophie Parish CYO.
* Yes, I/we likewise release from responsibility any persons transporting my/our child to or from the activities related to CYO activities.
* Yes, I, the parent or legal guardian, authorize all medical, surgical, diagnostic and hospital procedures as may be performed or prescribed by a treating physician for the above named participant if I cannot be reached in case of emergency.
If you have questions about the consent information, please contact Loretta in the Parish Office (425-747-6770 ext. 104, or email cyo@stmadeleine.org).
Please select your method of payment: Choose pay method VISA Mastercard American Express Discover JCB Check*
If paying by Credit Card, Credit Card Number: Expiration Date:
Name, address, city, state, zip, email & phone number of credit card.
*If paying by check, please mail in or drop off your check to the parish office (St. Madeleine Sophie Parish, 4400 130th Pl. SE, Bellevue, WA 98006, Attn: CYO SPORTS)
I would like to make an additional donation of: $ . Thank you!
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