BACK

** Applications filled out online can be paid with a CREDIT CARD or by mailing a check.

 

  already registered?   click here to make payment only 

 

Treasure Coast United Challenge

Stuart, Florida, USA

January 14/15, 2006

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

What is the Age Division of your team?  

 

Boys or Girls Team?         

 

Please enter your TEAM NAME::   Name

 

Enter your TEAM CODE in the space provided below.

  example B5PLM401BYS (do not type dashes)

Enter your CLUB AFFILIATION in the space provided below.

Enter your STATE ASSOCIATION in the space provided below.

Please provide the following COACH information:

Coach FIRST name

Coach LAST name

E-mail

Street Address

City

State/Province

Zip/Postal Code

Country

Work Phone

Home 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

Work Phone

Home 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

Work Phone

Home Phone

Cell Phone

Uniform COLORS:      primary jersey                alternate jersey

 

HOTEL Name     arrival date    departure date

 

According to the list below, enter the best estimate of your team's NUMERICAL RATING:

Comments: Please provide any additional information to help us evaluate your Team's strength (ex: state or regional cup team, tournament record, etc.)

 

 LEVEL choose one

 

*   I  will be responsible for staying current on tournament information by checking email and visiting the web site regularly.

 

When you click on "Submit Form" below, your application will be submitted,

and then on the next page you can begin the credit card payment section.

These are 2 separate processes.

 

Please only click ONCE on Submit  - it will take a few seconds.  

 

 


Author information goes here.
Copyright © 1999 [OrganizationName]. All rights reserved.
Revised: August 11, 2007