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 TEAM
INDIVIDUAL PLAYERS WILL FILL OPEN SPOTS AND WILL BE ASSIGNED 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 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 E-MAIL TO:tomulda@yahoo.com

http://www.southbrunswick.net/