2010 CDPHP SHAMROCK CUP – TEAM INFORMATION

 

CLUB NAME: _____________________________________________________

TEAM NAME:  ________________________PRIMARY COLOR:______________

AGE GROUP:             BOYS                                      GIRLS

                               ________U09 BOYS                         ______ U9 GIRLS         

                              ________ U10 BOYS                        ______ U10 GIRLS      

                              ________ U11 BOYS                                     ______ U11 GIRLS      

                              ________ U12 BOYS                                    ______ U12 GIRLS        

                              ________  U13 BOYS                                   ______ U13 GIRLS        

                              ________  U14 BOYS                        ______ U14 GIRLS                                                    

                              ________  HS BOYS                                       ______ HS GIRLS                                                        

                                               

TEAM COACH:    __________________________________ PHONE(H):__________________________

               ADDRESS: ________________________________ PHONE(C):___________________________

               CITY, ST., ZIP:__ ___________________________      EMAIL:    ___________________________

ASSISTANT: ______ __________________________PHONE (H):  ___________________________

               ADDRESS:___________________________PHONE (C): ___________________________

               CITY, ST., ZIP:_____________________________       EMAIL:  ___________________________

LEAGUE AFFILIATION:  ______________________________________________________

LEVEL OF PLAY (DIV 1, 2, “A” TEAM, ETC.)  _____________________________________

DOES YOUR TEAM PLAY IN A SELECT or ALL STAR LEAGUE ?          YES NO

DOES YOUR TEAM PLAY IN A PREMIER LEAGUE?                  YES     NO

MOST CURRENT YEAR’S LEAGUE RECORD: WON ____  LOST ____  TIE ____

PLEASE RETURN THIS FORM WITH ENTRY FEE.

MAKE CHECKS PAYABLE TO: Wappingers United Soccer Club / Shamrock Cup

 

MAIL TO:

2010 WUSC/ New York Soccer Academy Shamrock Tournament                                        

C/o Doug LaPerche

11 Ronnie Lane

Poughkeepsie NY 12601