(* indicates a mandatory field)
*Gender: BoysGirls *Age Group (Birthdate): U-8 (8/01/2001 - 7/31/2002) U-9 (8/01/2000 - 7/31/2001) U-10 (8/01/1999 - 7/31/2000) U-11 (8/01/1998 - 7/31/1999) U-12 (8/01/1997 - 7/31/1998) U-13 (8/01/1996 - 7/31/1997) U-14 (8/01/1995 - 7/31/1996) U-15 (8/01/1994 - 7/31/1995) U-16 (8/01/1993 - 7/31/1994) U-17 (8/01/1992 - 7/31/1993) U-18 (8/01/1991 - 7/31/1992) U-19 (8/01/1990 - 7/31/1991) *Team Name:
*Coach: Manager:
*Coach's Best Phone #: Manager's Best Phone #:
*Coach's Email: Manager's Email:
Send all mailings to:
*Contact Name:
*Address:
*City: *State: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY *Zip:
*Home Phone: Office: Fax:
*E-mail Address:
Yes No
Available Dates/Times will be Monday - Friday 6:00-7:00 p.m. or 7:00-8:00 p.m. during the dates listed below. Please enter the date/time you want to request in the box: December 7 - 18 January 4 - 29 February 1 - 26
Date/Time: All sessions will be confirmed with the DOC
Recreation Advanced Travel
For Travel Teams only: VSLI VCCL Other
Recent League Record:
Recent Tournaments:
Our team cannot play on: Saturdays Sundays, or on Date(s)
Please Note - I UNDERSTAND: · that I agree to fully abide by the provisions of SISL's Policies & Procedures Manual;·that Special Requests will be considered, but not necessarily granted; ·that no game schedule changes will be made during the season if I do not declare my team's conflict day(s) or date(s) on this Application; ·that if my team is not accepted, the entry fee will be refunded in full; that once my team is accepted (acceptance letters have been emailed, faxed, or mailed) that no refund will be made in the event of cancellation or shortening of any matches due to weather or conditions beyond our control; and, ·that no team is considered registered and will not be scheduled until ALL fees are paid.
In addition to this electronic application, you must provide a team roster, SISL Medical Release/Code of Conduct forms, a check for the appropriate fees, and complete an online Kidsafe Risk Management form. Make checks payable to Southside Indoor Soccer League. Fees and roster and medical release/code of conduct forms must be brought to Registration Night on November 18, 2009. A late fee of $50.00 will be added to the registration fee after 10:00 p.m. on November 18, 2009.