SOUTH BRUNSWICK ADULT SOCCER LEAGUE
REGISTRATION FORM
tomulda@yahoo.com

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

PLEASE READ RULES AND INFORMATION
PARTICIPANTS MUST BE 18 YEARS OR OLDER
USE THE REQUEST/COMMENT FIELD IF YOU ARE PART OF A GROUP OR A TEAM
INDIVIDUAL PLAYERS WILL BE ASSIGNED TO TEAMS ON AVAILABLE BASIS
PLAYERS WILL BE NOTIFIED OF THEIR TEAM ASSIGNMENT

FIRST NAME  
LAST NAME  
STREET  
CITY   STATE  ZIP CODE 
BIRTHDATE     mm/dd/yy AGE  GENDER 
COUNTRY OF BIRTH  
HOME PHONE   T - SHIRT SIZE T-Shirts are NOT provided,
but we may get a sponsor		   
WORK PHONE (EXT.)   x
CELL PHONE  
E:MAIL PREFERRED  
E:MAIL ALTERNATE  
PRIOR LEVEL OF PLAY(HS COLL)other league   PREFERRED POSITION  
COLLEGE  ATTENDED   FAVORITE
TEAM		  
EMERGENCY  CONTACT   EMERGENCY
PHONE #		  
MEDICAL/HEALTH INSURANCE PROVIDER   INSURANCE
POLICY #		  
 EMPLOYER   POSITION WITH
EMPLOYER		  
 PLEASE RECOMMEND
 A SPONSOR		  
 EXTRA   I AM A REFEREE      I CAN PLAY IN THE GOAL IF NEEDED
  I AM AVAILABLE TO VOLUNTEER HELP WITH THE LEAGUE
TEAM REQUEST
COMMENT or
QUESTIONS		  

After Clicking on "SUBMIT" -  print and Sign the Registration Form
make check payable to:   SBASL OR SOUTH BRUNSWICK ADULT SOCCER LEAGUE
PLEASE MAIL SIGNED REGISTRATION WITH CHECK TO THE ADDRESS PRINTED ON THE FORM
Thank You.
IF YOU HAVE ANY QUESTIONS E-MAIL TO: tomulda@yahoo.com
http://www.southbrunswick.net/