YMCA Fall Soccer 2026

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YMCA offers a beginner soccer program with smaller soccer balls and goals for younger players. A specially designed field, parental involvement and emphasis on FUN are key elements in this Y program, where every child plays! We believe in healthy competition, although kept in its proper perspective.

Participant Information

First Name

Last Name

Gender

Male
Female

Don't type in this field

Date of Birth

Divisions are based on the child's age.

U-6, U-8, and U-10

Ages 4-9

A child’s 4^th birthday must be before Sept. 1, 2026, and 10^th birthday cannot occur before Sept. 1, 2026.

Choose Division

Street Address

City

State

Zip Code

Select Your Shirt Size

Select Your Shorts Size

While we will attempt to accommodate your request, there are no guarantees. You may request being with a particular coach. Practice time/day are determined by coaches.

You may request to be on a team with another player, but we cannot make guarantees. Our goal is to make all teams fair and equal.

Coach Request

Player Request

Parent / Guardian Information

Parent/Guardian 1

Parent/Guardian 2

Phone 1

Phone 2

Participant Medical Information

Medical Conditions/Allergies

Emergency Contact Name

Emergency Contact Relationship

Emergency Contact Phone(s)

Coaches Needed

The strength of the Petal Family YMCA Youth Sports program depends on volunteer and parent participation. If you would like to coach your child's team please check the box below.

Volunteer - Coach

Name

Phone Number

Coach Shirt Size

Coach's Email

Volunteer - Asst Coach

Name

Phone Number

Coach Shirt Size

Coach's Email

Waiver

Permission For Enrollment and Release of The Family YMCA of Southeast Mississippi, Inc., from Liability: I am an adult over 18 years of age and wish to participate in The Family YMCA of Southeast Mississippi Inc., activities and/or I give my children permission to participate in YMCA activities. I understand that even when every reasonable precaution is taken, accidents can sometimes still happen. Therefore, in exchange for the YMCA allowing me to participate in YMCA activities, I understand and expressly acknowledge that I release the YMCA and its staff members from all liability for any injury loss or damage connected in any way whatsoever to my (or my children's) participation in YMCA activities whether on or off the YMCA's premises. I understand that this release includes any claims based on negligence, action or inaction of the YMCA, its staff, directors, members and guests. I have read and am voluntarily signing this authorization and release.

Waiver confirmation

I have read and agree with the waiver.

Concussion Fact Sheet

CLICK HERE

I Have Read the Concussion Fact Sheet

Registration Rate

YMCA Member $75 -The child must be listed on a current and active membership to the Petal or Hattiesburg Family YMCA.

Non Members $95.

The YMCA of Southeast MS's Financial Assistance Program provides families in need with financial scholarships to participate in the Y’s membership and program activities.

If you would like to apply for financial support for YMCA programs, click the link. Complete the financial packet and submit to the Petal Family YMCA Member Service desk or email Jessica at jjimendez@ymcasems.org by September 18, 2026, to apply.https://ymcasems.org/joining-our-ymca/financial-assistance/

If your child has already been approved and currently part of our scholarship program, please complete registration information and make payment at the Petal YMCA Membership desk where we can apply scholarship amount.

Registration Fee

Acknowledgement

I acknowledge that my child is not successfully registered until payment is complete. All payments must be received by September 27, 2026.

Would you like to make a donation to help provide scholarships for youth in our community that need it most?

100% of your gift will have an enduring impact right in our own community!

Scholarship donation

How did you hear about this program?

Ethnicity

Total Due:

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