2008Entry Form

A. Tournament Placement

Age Group - Select team placement for tournament

GU08

GU09

GU10

GU11

GU12

GU13

GU14

GU15

GU16

GU17

GU19

BU08

BU09

BU10

BU11

BU12

BU13

BU14

BU15

BU16

BU17

BU19

Division - Request division for tournament

Premier	USA Premier, Strong Upstate Travel, Strong D1, and Canadian Eastern Region.
TravelA	USA Upstate Travel, D1, D2 and Canadian Premier.
TravelB	USA D3, D4 and Canadian Division Level.

Are you willing you move up an age bracket or division? YES or NO

Please note: Final team placement will be determined by the tournament committee based on the number of entries and strength of the teams.

Team information - Complete in full

Team Name:

Club Name:

Club City:

Club State:

Country:

Can you play on Friday evening? YES or NO
(If you are not sure, select NO! Changes to Friday evening play will not be honored.)

B. Contact Information

Primary Contact Information - Complete in full

First Name:

Last Name:

Email Address:

Day Phone:

- -

Evening Phone:

- -

Cell Phone:

- -

Role :

Coach Assistant Coach Manager Other

Coach Contact Information - Complete in full

Are you the primary contact: YES or NO

If yes, proceed to part C - Team Information

First Name:

Last Name:

Email Address:

Day Phone:

- -

Eveining Phone:

- -

Cell Phone:

- -

C. Team Information

League Name:

New York State West Youth Association member: YES or NO

League Division:

New team this year: YES or NO

Last year's record:

Wins:

Loses:

Ties :

Tournament fee:
U8-U10 = $300.00
U11-U14 = $330.00
U15-U19 = $360.00

Send the tournament application along with fee to the Tournament Registrar:

Brockport Soccer Club
c/o Gail Barido-Maier
43 Frazier St.
Brockport, NY 14420

Please verify the information entered on this application form as requests for changes due to incorrect applications will NOT be honored.

Signature: _________________________________ Print name:____________________________ Date:___________________