One form per team Date

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WASL Warner Academy Soccer League

One form per team Date: _____________________________

Club/Team____________________________________

Team Contact:_________________________________

Team Coach: _______________________________

Cell Phone__________________________________

Coach’s Cell Ph________________________________

Email______________________________________

Coach’s Email: ________________________________

1) Does the coach have multiple teams participating? ___Y ___N If yes, which team(s)__________________ All Special request will be considered but due to field and time limitations may not be honored _________________________________________________________________________________________ My team is affiliated with: _____ FYSA ______ US Club

______Both

_______ We would like this to be State Cup Qualifying Match

Please check off the dates of participation. DAY DATE AGE

SITE

REGISTRATION DEADLINE

Academy ____Saturday ____Saturday Saturday ____Saturday

Thomasville, Ga Tallahassee Dothan, AL Tallahassee

Aug. 20th Sept. 3rd Sept 24th Oct. 1st

Tallahassee Navarre, FL Tallahassee

July 30th Aug. 27th Oct. 1st

September 8th September 22nd October 13th October 20th

Ages U9-U12 Ages U9-U12 Ages U9-U12 Ages U9-U12

**

Play date only

**The play date in Dothan, AL is scheduled and registered by Enterprise Futbol Club.

Premiere ____Saturday August 18th ____Saturday September 15th ____Saturday October 20th

Ages U13-U18 Ages U13-U18 Ages U13-U14(Only)

Club Registration (indicate teams participation by age group and gender) ____U10 ____Boy _____Girl

_____U13 ____Boy _____Girl

_____U16____Boy _____Girl

____U11 ____Boy _____Girl

_____U14 ____Boy _____Girl

_____U17____Boy _____Girl

____U12 ____Boy _____Girl

_____U15 ____Boy _____Girl

_____ U18____Boy _____Girl

Fee(s): 1- date: $150/ 2- dates: $275/ 3-dates: $400 Please return along with your entry fee to: Warner Soccer /WASL/1695-4 Metropolitan Circle/Tallahassee, FL 32308 (850) 386-3866 Fax (850) 386-5799 OFFICE ONLY Received: __________ Notes:

Paid:____________

Check_________

CC__________