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Team Name:
______________________________ Club Name ___________________________
State Affiliation:
___________________________ League: ______________________________
2006-2007 Age:
U- ______ Girls ___ Boys ___ Oldest Player Born After July 31,
19_______
Level: Gold
(Premier) _____ Silver (AAA) _____ Bronze (AA-A) _____ Other
_________
Team Contact
_____________________________________ Coach: _____ Manager: _____
Phone #:___________________
E-Mail:_____________________ Fax #:_____________________
(To be accepted, teams must provide an e-mail address)
Street/City/St/Zip:
__________________________________________________________________
| Past Performance |
(last 12 months) |
League: |
Wins___ |
Losses___ |
Ties___ |
Place___ |
| State Cup: |
National___ |
Open___ |
Wins___ |
Losses___ |
Ties___ |
Finish___ |
| Tourney ___________________________________ |
Wins___ |
Losses___ |
Ties___ |
Finish___ |
| Tourney ___________________________________ |
Wins___ |
Losses___ |
Ties___ |
Finish___ |
| Tourney ___________________________________ |
Wins___ |
Losses___ |
Ties___ |
Finish___ |
Please list
any special requests such as playing times, multiple teams with
same trainer/coach, etc.
___________________________________________________________________________________
Waiver
of Liability
If accepted, we agree to release, hold harmless
and indemnify the Santa Barbara Soccer Club
(SBSC), its Board of Directors, members, officials, coaches,
referees, sponsors and their employees, agents, officers
and directors from any and all liability for injury, or
damage to persons, property, or economic interests connected
with or arising out of any action taken by them in good
faith or out of any failure by them to act. In the event
of inclement weather or other force of Nature, SBSC shall
be the sole and exclusive judge of whether the tournament
shall be held, canceled, continued or postponed and we
hereby release SBSC and all the persons or entities mentioned
above from any and all liability for direct or consequential
damages resulting from the exercise by them of such judgment.
We understand that there will be no refund compensation
for lost games due to weather, forfeitures, or acts of
Nature as determined by the Tournament Committee. As the
representative of this team, I certify that the above information
is accurate and that each player registered to participate
in the tournament is covered by an approved medical insurance
plan as required by CYSA-S and SBSC. It is understood that
after acceptance, any and all refunds are at the sole discretion
of the Tournament Committee. We further understand and
agree that all age brackets will be played under the 2006-2007
playing year age designations.
Signed
by:_________________________________________ Date:______________
(Registered Team Coach or Club Official Only)
Mail
To: Brian Hersh, 379 Princeton Avenue, Santa Barbara CA 93111
Please Complete and Return with the Player Roster
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