TOPSoccer for 2017 / 2018 CAPITAL SOCCER ASSOCIATION www.capitalsoccer.com
REMOVE AND MAIL TO:
237 South 70th Street #201 Lincoln, NE 68510
Phone: (402) 464-5425
[email protected] NEBRASKA STATE SOCCER ASSOCIATION US YOUTH SOCCER UNITED STATES SOCCER FEDERATION
CAPITAL SOCCER ASSOCIATION Fall 2017 Indoor 2018 Spring 2018 Season Players - Last Name: First Name: Address: ______________________________ City: Zip: Home Phone: Birthdate: _____/_____/_____ Gender: Last 4 digits of Social Security Number: _______________________________ Cell (Player or main contact): ____________________________
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School Attending__________________________email#1:_______________________email#1:_________________________ Contact - Father’s Name: Cell Phone: Mother’s Name: Cell Phone: All new players to Capital Soccer must include a copy of their birth certificate
T.O. Haas/Uniroyal TOPSoccer $60 Registration Fee for Fall Outdoor 2017, Indoor 2018 & Spring 2018. I wish to make a donation of $_________ to the TOPSoccer schlorship fund I wish to volunteer to be a Team parent. Please contact me. If you are new to CSA or need a new uniform please circle your sizes needed. You can pick up your uniform from the CSA office at the Abbott Tennis Center or it will be at the field. TOPSoccer uniform Please circle size needed: Tshirt: YM, YL, AS, AM, AL, AXL Soccer Shorts: YM, YL, AS, AM, AL, AXL Socks: Youth, Intermediate, Adult
Our Spring, Fall & Indoor season’s played at Speedway Village Soccer Fields (345 Speedway Cir), Fall: We will play on Sunday’s at 1:00 p.m. beginning 9/17/17 & our last session will be 10/15/17. Indoor: We will play on Saturday’s at 1:00 p.m. beginning 1/13/18 & our last session will be 2/10/18. Spring: We will play on Saturday’s at 1:00 p.m. beginning 4/7/18 & our last session will be 5/5/18.
Financial Assistance is available on request. No player is turned away! Please provide cell and email, most correspondence is done through text and email. WAIVER - Coaches, managers, umpires, referees, their assistants or anyone who prepares any playing field shall NOT be liable for the injury or death of any participant in Capital Soccer Association soccer programs or activities which results from the negligence of any of the above listed individuals. In addition, I give Capital Soccer Association my consent to take and use photographs of my child/ren during Capital Soccer Association activities. Parent/Guardian Signature _____________________________________________________________
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CSA Contact:TOPSoccer Coach & Coordinator: Rob Nixon Cell:402-202-7821 Email:
[email protected]