SOUTH BRUNSWICK ADULT SOCCER LEAGUE
REGISTRATION FORM

CONCERNED ABOUT THE DEADLINE?
EMAIL tomulda@yahoo.com
TO SEE IF IT’S STILL OK TO SIGN UP

TO REGISTER:
(1) Fill-Out this form
(2) Click SUBMIT REGISTRATION
(3) Print Confirmation Page
(4) Sign Waiver/Registration
(5) Mail Confirmation with $85 Check

PLEASE READ RULES AND INFORMATION
PARTICIPANTS MUST BE 18 YEARS OR OLDER
PLAYERS WILL BE GIVEN THEIR TEAM'S NAME AND SCHEDULE PRIOR TO START

 FIRST NAME  
 LAST NAME  
 STREET  
 CITY   STATE  ZIP CODE 
 BIRTHDATE     mm/dd/yy AGE  GENDER 
 COUNTRY OF BIRTH  
 HOME PHONE   T - SHIRT SIZE    
 WORK PHONE (EXT.)   x
 CELL PHONE  
 E:MAIL PREFERRED  
 E:MAIL ALTERNATE  
PRIOR LEVEL OF PLAY(HS COLL)other league   PREFERRED POSITION  
 EMERGENCY  CONTACT   EMERGENCY
PHONE		  
 MEDICAL/HEALTH INSURANCE PROVIDER   INSURANCE
POLICY #		  
 EMPLOYER   POSITION WITH
EMPLOYER		  
 PLEASE RECOMMEND
 A SPONSOR		  
 SCHEDULE CONFLICT
 MARK SUNDAYS
 NOT AVAILABLE  		  NOT AVAILABLE: PLEASE CHECK ALL SUNDAYS THAT YOU CANNOT PLAY
JUNE 22 June 29   JULY 6   JULY 13  JULY 20   JULY 27
AUG 3    AUG 10   AUG 17
 EXTRA   I AM A REFEREE      I CAN PLAY IN THE GOAL IF NEEDED
  I AM AVAILABLE TO VOLUNTEER HELP WITH THE LEAGUE
 TEAM REQUEST
OR OTHER
 COMMENT 		 

NEXT STEP after "submit" is to print confirmation page, SIGN and make check payable to:
SBASL OR SOUTH BRUNSWICK ADULT SOCCER LEAGUE

PLEASE MAIL SIGNED CONFIRMATION SHEET WITH CHECK TO:
SBASL
Tom Kauders
11 Victoria Way
Kendall Park, NJ 08824

IF YOU HAVE ANY QUESTIONS CALL 908-770-7285, OR E-MAIL TO:tomulda@yahoo.com

http://www.southbrunswick.net/