City of Plattsburgh
Indoor Soccer
Waiver to move player up or down
I, ________________ permit my child _______________,
born: _______________,
to move from the ____________(ex: U-8/U-10) division
up/down (circle) into the _____________ division.
REASON: __________________________________________
-pending the City of Plattsburgh Recreation Leader’s consent.
__________________________________ ____________
Signature of Parent/Guardian Date
__________________________________ ____________
Signature of Recreation Leader Date
please print out and drop off to the Recreation Dept. (52 us oval)