invoice: WTSAB Data entry form

Player Registration Form - Fall 2014
 
Online registrations must be paid via credit card

Any questions regarding online registrations contact wt.soccer@comcast.net 

Fields in red are required
 
 
Players First Name:  Middle Initial:
Last Name: 
  Address:  
  City: State:ZipcodeAreaCodePhone#
 Confirmation will be sent to this email address

Primary Email:

Confirm Email



Date of Birth Gender:Male Female

This Player Registering for


Travel players must attend at least (1) tryout date in order to be considered for selection on a travel team.
Travel Registration fee does not include uniform fee, uniforms will be purchased through each travel team's coach.
Age as of 7/31:
Best Friends Division for
Physically or Mentally
Challenged Players of all ages.
For Best Friends Division
players over 18:
enter year of birth
School Currently Attending Current Grade
The Washington Township Soccer Advisory Board and the travel soccer program rely on the fundraising and volunteer efforts of its board, coaches, and parents. By registering to play travel soccer I agree to participate in all Soccer Advisory Board fundraising activities and to provide a minimum of two hours of volunteer effort per child for each season my child(ren) play travel soccer for Washington Township. While it is anticipated the majority of this volunteer requirement will be for the annual tournament, the assignment of volunteer work will be at the discretion of Soccer Advisory Board.
I agree to meet the minimum volunteer requirement



Comments or Special Requests Use this field if: 1.New to WTPR Soccer, if so please list previous experience. 2.Requesting a specific coach (CLINIC ONLY). 3.Any special needs or requests.
 
Any special needs or medical condition a coach should know of:
Parent Information
Mother/Guardian- First Name Last Name
Address  Same as Child 
Street
Street
 City:  State:ZipcodeAreaCodePhone#      
Email
Father/Guardian- First Name Last Name
Address Same as Child 
Street
Street
 City:  State:ZipcodeAreaCodePhone#      
Email

Emergency Contact
Name Phone Number

Volunteer Information
Volunteers NameArea CodePhone#
Check all that apply
Do you wish to volunteer as HEAD coach?
Do you wish to volunteer as an assistant coach?

Check here if form is complete