Palm Bay Spring Challenge

Do NOT hit the ENTER key !   Use the TAB key to move around.  When you are finished, select SUBMIT at the bottom of the form

TEAM APPLICATION

 * indicates fields which must be filled out

* What is the Age Division of your team? choose age group under 08 (playing under 09) under 09 under 10 under 11 under 12 under 13 under 14 under 15 under 16 under 17 under 18 under 19  

* Boys or Girls Team? Choose Boys or Girls BOYS/Coed GIRLS

* Team Name

Team Code   example B5-PLM-401-BYS (do not type dashes)

* Club Affiliation

State Association

Please provide the following COACH information:

*Coach FIRST name
*Coach LAST name
E-mail
Street Address
City
State/Province
Zip/Postal Code
Country
Home Phone
Work Phone
Cell Phone

Please provide the following ASSISTANT COACH  information:

Assistant FIRST name
Assistant LAST name
E-mail
Street Address
City
State/Province
Zip/Postal Code
Country
Home Phone
Work Phone

Please provide the following CONTACT information:

This person will receive ALL communication - and must have an email address!

*Contact FIRST name
*Contact LAST name
*E-mail
*Street Address
*City
*State/Province
*Zip/Postal Code
Country
*Home Phone
Work Phone
Cell Phone

Uniform colors:      primary jersey                alternate jersey

Hotel Name        arrival date       departure date

* According to the list below, choose the best estimate of your team's numerical rating:

RATE YOUR TEAM..... 100. Best in the World 95. Possibly in the Top 10 in the USA 90. Possibly in the Top 10 in your State 80. Very strong Competitive Team with good credentials 70. Capable Competitive Team 60. Developing and Improving Competitive Team 50. New, Inexperienced Competitive Team 40. Inexperienced Comp Team very little success against others 30. Very strong Travel Rec team with Comp level guest players 20. Strong Rec. Team (no tryouts, no recruiting) 10. Average Rec Team (no tryouts, no recruiting) 0. Expecting the beaches/tourist attractions to be highlight

Please provide any additional information including team history for the past 2 years.

* LEVEL choose one:

  State Cup Regional Cup Recreational Other

* NO YES   I  will be responsible for staying current on tournament information by checking email and visiting the web site regularly.