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TEAM APPLICATION
Team Name:____________________________________
Select Session and League: ___ Session I 2009 Nov 2nd Start Date
___ Session II 2010 Feb 1st Start Date ___ Girls U-10A Soccer ___ Adult Men’s-A Soccer
___ Boys U-10A Soccer ___ Girls U-10B Soccer ___ Adult Men’s-B Soccer
___ Boys U-10B Soccer ___ Girls U-12A Soccer ___ Adult Coed Soccer
___ Boys U-12A Soccer ___ Girls U-12B Soccer ___ Adult Men's Sunday nights
___ Boys U-12B Soccer ___ Girls U-14A Soccer
___ Boys U-14A Soccer ___ Girls U-14B Soccer
___ Boys U-14B Soccer ___ Girls 15u Soccer
___ Boys 15u Soccer ___ Girls 16u Soccer ___ Boys 16u Soccer ___ 8u Coed Soccer ___ Early Registration Price Deadline OCT 18th ___ 6u Coed Soccer *ALL days/times subject to change based on availability and number of entires
_______________________________________ ______________________________________
Primary Contact Title (Coach, Manager, Assistant Coach)
___________________________________________________________________________________
Address
_______________________________________ ______________________________________
Telephone (h) Telephone (w)
___________________________________________________________________________________
E-Mail Address
_______________________________________ ______________________________________
Secondary Contact Title (Coach, Manager, Assistant Coach)
___________________________________________________________________________________
Address
_______________________________________ ______________________________________
Telephone (h) Telephone (w)
___________________________________________________________________________________
E-Mail Address
Payment Method: ___ Cash (in person only) ___ Check (by mail or in person)
___ Credit Card (Card Number):______________________________ Exp.Date_____
A completed application and $150 deposit is required for each team unless early registration applies. Space is limited.
YOU WILL NOT BE PLACED ON THE SCHEDULE WITHOUT AN APPLICATION and DEPOSIT Applications are received on a first come, first served basis, and all deposits are NON REFUNDABLE.
Mailing: 6 Fargo Rd, Waterford CT 06385 _____________________________
Signature of Team’s Primary Contact
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