Colfax Youth Soccer Registration - Palouse Empire Recreation Organization

Colfax Youth Soccer League
Colfax, WA 99111

Registration Cost: $26.50 per player
Beginning in 2026, Registration is online only
Practices begin Sept. 14, 2026 | Games begin Sept. 26, 2026
Email Colin Haffner at: [email protected] for additional information or questions

Player's Name

Enter the player’s full name.

Player's Gender

Enter the player’s gender.

Player's Grade

Player’s grade in 2026-27 schoolyear.

Player's Shirt Size

Player’s shirt size

Player's Preferred League (If playing up a level)

Player’s preferred playing level. Preference is not a guarantee and must be approved by Colfax Youth Soccer leaders.

Player's Team (If outside of Colfax)

Name of team player will be on if not playing on a Colfax team.

Player's Name being

Parent/Guardian Name(s)

Enter the names of parent(s) or guardian(s).

Home Address

Enter the player’s home address.

Parent/Guardian Phone Number (Primary)

Primary contact phone number for parent or guardian.

Parent/Guardian Phone Number (Secondary)

Secondary contact phone number (optional)

Parent/Guardian Email Address

Email address for parent or guardian.

Emergency Contact Name

Name of someone to contact in case of emergency.

Emergency Contact Phone Number

Phone number for emergency contact.

Player's Health Attestation

Please list any relevant health concerns or attest that the player is in good health to participate.

Player's Allergies

List any allergies the player has. If none, write ‘None’.

Volunteer Coach

I would like to volunteer as a coach

Check if you are interested in volunteering as a coach.

Volunteer Coach Name

Name of volunteer coach.

Volunteer Coach Email

Volunteer coach email address.

Interested in being a Referee?

I would like to be a Referee

Check if you, or your youth player are interested in serving as a Referee during the 2026 soccer season. Referees must be eligible for the grade 4-6 level or older.

Referee Name

Name of interested Referee.

Referee Email

Email contact of interested Referee.

Liability Waiver Agreement

I agree to the Liability Waiver

I, in consideration of the above named participant’s acceptance of entry into the Colfax Youth Soccer League, hereby assume for the named participant all risks and hazards of the conduct of this league-sponsored recreation program and release for myself, the named participant, my heirs, executors, and administrators any and all claims and rights for damages I/the named participant may have against the Colfax Youth Soccer League and participating agencies, employees, and volunteers connected with the program. I specifically release and hold harmless the Colfax Youth Soccer League and its agents, employees, and volunteers from any liability which may arise from the negligence of the participating agencies, employees, volunteers, and others involved with the program. I also acknowledge for myself/ Named participant that the Colfax Youth Soccer League provides restricted medical coverage for any accidents or injuries that might result during participation in League-sponsored activities. I have read and understand these registration policies. I understand registration is invalid without my acknowledgement.

Concussion Protocol Agreement

I understand and agree to the Concussion Safety Protocol found at www.wiaa.com/health-wellness/

WHAT IS A CONCUSSION? A concussion is a brain injury that is caused by a bump or blow to the head. It can change the way your brain normally works. It can occur during practices or games in any sport. Even a “ding” “getting your bell rung,” or what seems to be a mild bump or blow to the head can be serious. A concussion can happen even if you haven’t been knocked out. You can’t see a concussion. Signs and symptoms of a concussion can show up right after the injury or may not appear or be noticed until days or weeks after the injury. If your child reports any symptoms of concussion, or if you notice the symptoms yourself, seek medical attention right away. Coaches / Parents / Legal Guardian What are the signs and symptoms of a concussion observed? If your athlete has experienced a bump or blow to the head during a game or practice, look for any of the following signs and symptoms of a concussion: • Appears dazed or stunned • Is confused about assignment or position • Forgets an instruction • Is unsure of game, score, opponent • Moves clumsily. • Answers questions slowly • Loses consciousness (even briefly) • Shows behavior or personality changes • Can’t recall events prior to being hit or falling * Can’t recall events after being hit or filling How can a coach/ parent / legal guardian help their athlete prevent a concussion? Every sport is different, but here are steps your athletes can take to protect themselves from a concussion. Ensure they follow rules for safety and the rules of the sport. Encourage them to practice good sportsmanship at all times. Make sure they wear the right protective equipment for their activity (such as helmets, padding, shin guards, and eye and month guards). Protective equipment should fit properly, be well maintained, and be worm consistently and correctly. Learn the signs and symptoms of a concussion. Want should a coach/ parent/ legal guardian do if they think their athlete has a concussion? 1. Tell the parents and have them seek medical attention right away. A health care professional will be able to decide how serious the concussion is and when it is safe lor their child to return to sports. Listen to the parents and their concerns about concussion or bead injuries. 2. Keep your athlete out of play. Concussions take time to heal. Don’t let your athlete return to play until a health care professional says if’s OK. Children who return to play too soon-while the brain is still healing risk a greater chance of having a second concussion. Second or later concussions can be very serious. They can cause permanent brain damage, affecting your child for a lifetime. 3. Keep informed about any recent concussion in ANY sport or activity. You may not know about a concussion your athlete received in another sport or activity unless you ae told by the parents.

Photography Release

I agree to the Photography Release

I hereby grant Colfax Youth Soccer, its representatives, employees, and authorized agents, the irrevocable and unrestricted right to use and publish photographs or videos taken of me/my child during youth soccer events, for editorial, trade, advertising, educational, and any other lawful purpose, in any manner or medium. I waive any right to inspect or approve the finished product or the use to which it may be applied. I also release Colfax Youth Soccer from any claims, damages, or liability arising from or related to the use of the photographs/videos. I understand that no compensation will be provided for the use of these images or recordings.

Checkbox Items

Register for Youth Soccer – $26.50
I’d like to pay so others can play – $26.50
I’d like to donate to the Saturday Morning Basketball Program – $10.00
I will volunteer as a coach – $1.00

Choose registration and payment options. A minimum fee is required to process all registrations. Volunteer coach fees will be refunded.

Stripe Credit Card

Acknowledgement

By completing and submitting this registration on behalf of the named participant, I acknowledge that I am a legal parent or guardian of said participant and I hereby agree and accept all terms and conditions set forth in this Player Information, waiver and disclosures form.