Website Manager


Piedmont Area Recreation Association

News Detail


Jan, 2018


Tryouts will be held:

Girls                                                                                                                                      Boys

January 28th – January 29th                                                                                                                                         January 30th  - January 31st


 Before your child will be allowed to tryout, you must fill out the following forms and bring them to the first day of try-outs. Forms can be found under the Piedmont Middle School Athletics Information web-site:

*** Completed forms must be turned in before being allowed to try-out.***


  1. Participation Form
  2. Student Insurance Waiver (Needs to be Notarized)
  3. Student Athlete Concussion Statement (Signed by Parent and Student)

    **Please go to ** to read

  4. Consent Form – Attached (Filled Out)
  5. Players cannot be 15 years old before AUGUST 31st 2018

Team Information: Please initial next to each statement indicating that you have read and understand.

_____   We will be rostering 16 players on both the boys and girls teams.

Five additional players may or may not be selected as “developmental players”.

  • Being selected as a developmental player means that the player may attend all practices and dress for every game but playing time will not be guaranteed for any game.
  • Rostered players are guaranteed to play a minimum of five minutes per half

Making the Team:   A list of Players who made the team(s) will be posted outside the main office a day or two after completed tryouts (Both Boys and Girls).  It will have information about the first practice.  Please initial next to each statement indicating that you have read and understand.

_____   If selected, the cost to participate will be:

  • $260.00 per rostered player
  • $200.00 per developmental player.
  • Payment will need to be made the first week of practice.If no payment is made, your child will not be eligible to practice or play in the games.
  • Uniforms will not be ordered until first payment is made.
  • Checks made payable to PASA – Middle School Soccer
  • Ask for Credit Card Payment information


_____   Additional Forms that will need to be filled out once you have been selected for the team. These forms can be found

  1. Copy of player’s birth certificate (Need first week of Practice)
  2. Physical Form 2018 (Filled out and Signed by Physician)(Once every 365 days)
  3. Concussion Test
  4. Emergency Contact Form


_____   Players will be required to be ready for practices and games, including proper attire (winter clothes if necessary), equipment (Cleats, Shin Guards), and provide proper hydration (Water Bottles) and will be required to respect the school facilities (Inside and Out).

  • Players missing one practice without a valid reason will not start or have playing time reduced.
  • Players missing two practices without a valid reason will not play in the next game.


    Continued on Back - Please turn Sheet Over



    _____   Practices will be twice a week:

  • Monday and Wednesday or
  • Tuesday and Thursday
  • Parents must be at the school to pick their child up from practice at 5:30pm.


    _____   Parents responsibilities:

  • Must be at the school to pick their child up from practice at 5:30pm.
  • Must provide their child’s transportation to/from all games. Most game times will either be 6:00 or 7:30pm
  • Will be asked to help man the gate or concessions at home games… a schedule will be made to accommodate everyone.
  • Will be respectful of other players, coaches and referees.


The goal of this program is to create a boys and girls soccer team (made up of students enrolled at Piedmont Middle School) to play other similarly created teams from other Union County Middle Schools.  Following NCHSAA rules and guidelines we stride to develop and prepare these players as the move on to the high school program. 

Quick Rules and Information:

  1. Both boys and girls games will be played on the same day.
  2. Games will have 35 minute halves, 5 minute break in between and NO OVERTIME
  3. Each GAME DAY ROSTERED PLAYER is guaranteed (minimum) 5 minutes of play per half.
  4. Developmental Players are allowed to sit on the bench with the team during games. These players will not see any playing time unless the coach has assigned them to that GAME DAY ROSTER.
  5. A 6 goal differential is all that will be tolerated, no running up the score.
  6. Gate Fees will be $4 for Adults and $1 for Kids over 2 years, some schools will have higher gate fees.
  7. Only players and coaches are allowed on the field.Parents and Visitors must stay in the stands.
  8. Un-Sportsmanship Behavioral by anyone (Player, Parent, and Visitor) will not be tolerated and those persons will be removed from the facility.


Any additional questions can be directed to Rick Cantwell ([email protected]).

Parent Signature: _________________________________    Date:  _______________________

Student Name: ___________________________________   Grade: ______________________



Middle Grade Soccer Team Try Outs Consent Form

Girls                                                                                                      Boys     

Monday Jan 28th 3:30pm - 5:00pm                                                            Wednesday Jan 30th  3:30pm - 5:00pm

Tuesday Jan 29th 3:30pm - 5:00pm                                                            Thursday Jan 31st   3:30pm - 5:00pm 



Please wear appropriate clothing, bring water and arrange transportation home.



This Consent Form signed, AND a COPY of Birth Certificate to tryouts.


*STUDENT NAME:_________________________________________________

*DATE OF BIRTH: __________________________                 GRADE: _________

  ADDRESS: _______________________________________________________

  CITY/STATE/ZIP: __________________________________________________


*MOTHER’S NAME: ________________________________________________

*MOTHER’S EMAIL: ________________________________________________

*PHONE (Home): _________________                   Work: ___________________


*FATHER’S NAME: _________________________________________________

*FATHER’S EMAIL: _________________________________________________

*PHONE (Home): _________________                   Work: ___________________


*EMERGENCY CONTACT NAME: ______________________________________

*PHONE: _________________________________________________________

* Required Information


Parent’s signature indicates consent for their child to try out and play soccer on the Middle Grades Soccer Team.


We, the parents or legal guardian, release, discharge, and agree to hold harmless and indemnify the Piedmont High Booster Club, Piedmont Middle School and/or any coach or manager of the team from any or all liability, claims or demands arising from the minor child participating in the soccer program.


PARENT’S SIGNATURE: ___________________________________________________

DATE: _________________________________________________________________


Contact us by phone or email if you have any questions:



Rick Cantwell        704-724-2667                      email: [email protected]



Student-Athlete & Parent/Legal Custodian Concussion Statement


Because of the passage of the Dylan Steiger’s Protection of Youth Athletes Act, schools are required to distribute information sheets for the purpose of informing and educating student-athletes and their parents of the nature and risk of concussion and head injury to student athletes, including the risks of continuing to play after concussion or head injury.  North Carolina law requires that each year, before beginning practice for an organized activity, a student-athlete and the student-athlete’s parent(s)/legal guardian(s) must be given an information sheet, and both parties must sign and return a form acknowledging receipt of the information to an official designated by the school or school district prior to the student-athletes participation during the designated school year.  The law further states that a student-athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from play at the time of injury and may not return to play until the student-athlete has received a written clearance from a licensed health care provider. 


Student-Athlete Name:  _________________________________________________________________________

This form must be completed for each student-athlete, even if there are multiple student-athletes in each household.  


Parent/Legal Custodian Name(s):  _________________________________________________________________


□  We have read the Student-Athlete & Parent/Legal Custodian Concussion Information Sheet.  This can be found at

**If true, please check box


After reading the information sheet, I am aware of the following information:

Student-Athlete Initials


Parent/Legal Custodian Initials


A concussion is a brain injury, which should be reported to my parents, my coach(es), or a medical professional if one is available.



A concussion can affect the ability to perform everyday activities such as the ability to think, balance, and classroom performance.



A concussion cannot be “seen.” Some symptoms might be present right away. Other symptoms can show up hours or days after an injury.



I will tell my parents, my coach, and/or a medical professional about my injuries and illnesses.



If I think a teammate has a concussion, I should tell my coach(es), parents, or licensed health care professional about the concussion.



I will not return to play in a game or practice if a hit to my head or body causes any concussion-related symptoms.



I will/my child will need written permission from a licensed health care professional to return to play or practice after a concussion.



After a concussion, the brain needs time to heal. I understand that I am/my child is much more likely to have another concussion or more serious brain injury if return to play or practice occurs before concussion symptoms go away.



Sometimes, repeat concussions can cause serious and long-lasting problems.



I have read the concussion symptoms on the Concussion fact sheet.



____________________________________________________________                    _____________________

Signature of Student-Athlete                                                                                                                           Date


____________________________________________________________                    _____________________

Signature of Parent/Legal Custodian                                                                                                              Date


TO:  Parents of Students Participating in Athletics

DATE:  ____________________________________ 


SCHOOL: ____________________________________ 

SPORT:  ____________________________________ 


The Union County Board of Education requires that the student insurance offered will be compulsory for all students participating in junior and senior high school athletics unless a notarized insurance waiver form is signed by the parent indicating adequate personal insurance and releasing the Board of Education and its employees from responsibility for any claim due to injuries received while participating in a school sponsored athletic program.  Please be sure that you understand the following before deciding whether to permit your son or daughter to participate: 

1. There are limitations in the Student Accident Insurance coverage.  It will not always pay all charges for every accident.  Read the description of the current Student Accident Insurance carefully and be sure that you understand it. 

2. Neither the Board of Education nor any of its employees will assume responsibility for claims resulting from injury to your child while he/she is participating in this program.  This means that you will have to pay for any necessary medical treatment not covered by the Student Accident Insurance or any personal insurance coverage that you might have. 

In view of this Board policy and the current Student Accident Insurance coverage, I wish to proceed as follows (check one, sign, No. 3 must have notary signature, and return promptly): 

1. ________ Enclosed please find $______________ for Student Accident Insurance.  I understand that I am responsible for payment for any charges not covered by this policy. 

2. ________ My son/daughter is already enrolled in the Student Accident Insurance Program, and I understand that I am responsible for payment of any charges not covered by this policy. 

3. ________ I have adequate personal insurance and release the Board of Education and its employees from any responsibility in this matter. 


SIGNED (Parent or Legal Guardian): ________________________________________________________


STUDENT’S FULL NAME__________________________________________________________________ 

DATE: ________________________________________________________________________________

(if Item No. 3 is checked, the following must be completed.) 


I, ___________________________________, a Notary Public of _____________________ County and State of _________________ do certify that _______________________________________ personally appeared before me this day and acknowledged the due execution of the foregoing instrument. 


Witness my hand and official seal, this the _________________ day of _______________, 20_________. 




My Commission Expires: _________________________________


Each player must also receive a MEDICAL EXAMINATION by a physician licensed to practice medicine each calendar year (once every 365 days) in order to be eligible for practice or participation in interscholastic athletic contest.  This verification must be in hands of Athletic Director prior to participation.

Contact Us

Piedmont Recreation Association

3504 Zebulon Williams Road. 
Monroe, North Carolina 28110

Email Us: [email protected]
Copyright © 2021 Piedmont Area Recreation Association  |  Privacy Statement |  Terms Of Use |  License Agreement |  Children's Privacy Policy  Login