Form Center

2. 
4. Soccer Team Information
6. Coach's Name*
7. Team Name
8. Age Group or Grade *
9. Gender*

   1. Boys
   2. Girls
11. Cell Phone #*
12. Email Address*
13. Jersey Color*

    Please note everyone will be getting new jerseys this fall.  Returning coaches please enter your current jersey color (if you'd like to keep that color).  If you prefer a new color, please list your top three choices from list below.

    New coaches, please enter your top three jersey color preferences from list below..

    Jersey color options are maroon, orange, red, white, turquoise, purple, neon yellow, neon blue, mint, navy, black, green, lime, hot pink, silver, gold, forest green, royal blue, & Columbia blue.

14. Do you prefer JCPRD to add players to your team? (no guarantee)

    1. Yes
    2. No
16. Game Scheduling Conflicts
18. A max of up to two scheduling conflict requests are allowed for kindergarten - 4th grade. No conflicts are allowed for 5th - 8th grade teams but a reschedule request is possible if your team has a conflict.
20. Two scheduling conflict requests mean two specific dates, or a certain time on a specific date or dates where your team will be unable to play. You cannot request to not play on Sundays or a specific time each week.
22. Any rescheduling request must be requested 10 days prior to the originally scheduled date of the game or the game will not be rescheduled. You will be required to play the game or forfeit.
24. Please be sure to also list if you are coaching multiple teams and their age group. Also be aware that assistant coaches are expected to coach in the absence of the head coach.
26. Conflict # 1
27. Conflict # 2
30. Other team(s) coaching
31. Age Group or Grade
32. Gender

    1. Boys
    2. Girls
34. Practice Field Request (Grades 1 - 8 only)
36. Please indicate your preferred practice options below. Please note teams are guaranteed one 60-minute practice per week. Teams who would like a second practice can indicate that but may not be possible based on field availability. Coaches will be emailed their practice schedule by the end of February for spring and the end of July for fall.
38. Day Request # 1
39. Day Request # 2
40. Day Request # 3
42. Preferred Location

    1. Heritage Soccer Park
    2. Stoll Park (goals no longer available)
    3. Oak Park Carpenter
    4. Pawnee
43. Time of Day Request

    1. 5:00 - 6:00
    2. 5:30 - 6:30
    3. 6:00 - 7:00
    4. 6:30 - 7:30

    Please choose your top 2 options.
44. Would you like a second practice each week if possible?

    1. Yes
    2. No
Leave This Blank:


46. 1. Receive an email copy of this form.
47. Email address

    This field is not part of the form submission.

48. Submit

* indicates a required field