Team Roster / Registration Form
Team Name:____________________________ Club Affiliation__________________________________
Primary Contact:________________________________________________________________
Cell Number:_____________________________
Email:___________________________________________________________________________
Address:_________________________________________________________________________
City:___________________________ State:______________________ Zip____________________
Age Division (Circle one) Coed-U7/8 Boys or Girls U9 U10 U11 U12 U14 U18
Gender Girls_____ Boys_____ Coed_____
Team Experience (Circle one) Rec Travel Premier
List Names of Players: Waiver for each player must be completed. Birth Certificate (copy) or current player cards will be required at event for each player.
1)Player Name_________________________________________________Birth Date:_____/_____/_____
2)Player Name_________________________________________________Birth Date:_____/_____/_____
3)Player Name_________________________________________________Birth Date_____/______/_____
4)Player Name__________________________________________________Birth Date____/______/_____
5)Player Name__________________________________________________Birth Date____/______/_____
6)Player Name__________________________________________________Birth Date____/______/_____
Name of Coach:__________________________Phone Number(_____)____________________
Email:__________________________________________________________________________
Registration fee for 3v3 tournament is $120. Goalie Wars $35 per goalie. Checks can be made out to:
Plainfield Soccer. Mail Payment to: Plainfield Soccer Club, P.O. 215 Central Village, CT 06332-0215.
Form Of Payment:______Check______Cash.
Signature_______________________________Date________________
Team Name:____________________________ Club Affiliation__________________________________
Primary Contact:________________________________________________________________
Cell Number:_____________________________
Email:___________________________________________________________________________
Address:_________________________________________________________________________
City:___________________________ State:______________________ Zip____________________
Age Division (Circle one) Coed-U7/8 Boys or Girls U9 U10 U11 U12 U14 U18
Gender Girls_____ Boys_____ Coed_____
Team Experience (Circle one) Rec Travel Premier
List Names of Players: Waiver for each player must be completed. Birth Certificate (copy) or current player cards will be required at event for each player.
1)Player Name_________________________________________________Birth Date:_____/_____/_____
2)Player Name_________________________________________________Birth Date:_____/_____/_____
3)Player Name_________________________________________________Birth Date_____/______/_____
4)Player Name__________________________________________________Birth Date____/______/_____
5)Player Name__________________________________________________Birth Date____/______/_____
6)Player Name__________________________________________________Birth Date____/______/_____
Name of Coach:__________________________Phone Number(_____)____________________
Email:__________________________________________________________________________
Registration fee for 3v3 tournament is $120. Goalie Wars $35 per goalie. Checks can be made out to:
Plainfield Soccer. Mail Payment to: Plainfield Soccer Club, P.O. 215 Central Village, CT 06332-0215.
Form Of Payment:______Check______Cash.
Signature_______________________________Date________________