ADULT “WAITING LIST” REGISTRATION FORM
Team fee for the 2010-2011 seasons: $650.00 (Summer '11 Special = $630.00)
| [ ] |
First Fall ‘10 (begins late August) |
|
[ ] |
Second Fall '10 (begins late October) |
|
[ ] |
Winter '11 League (begins early January) |
|
[ ] |
Spring '11 League (begins mid March) |
|
[ ] |
Summer '11 League (begins early June) |
----------------------------------------------------------------------------------------------------------------------
|
[ ] |
Men’s Div 1 (___A) (___B) |
[ ] |
Women's Div 1 |
|
[ ] |
Men’s Div 2 (___A) (___B) |
[ ] |
Women's Div 2 (___A) (___B) |
|
[ ] |
Men’s Div 3 (___A) (___B) |
[ ] |
Women's Div 3 (___A) (___B) |
|
|
|
[ ] |
Women’s Div 4 (no standings, goal limit) |
|
[ ] |
Recreational Coed (21 & over) Division 1 (no goal limit) |
|
[ ] |
Recreational Coed (21 & over) Division 2 (goal limit) (___A or ___B) |
|
[ ] |
Recreational Coed (21 & over) Division 3 (goal limit) (___A or ___B) |
|
[ ] |
Recreational Coed (21 & over) Division 4 (goal limit) (___A or ___B) |
|
[ ] |
Recreational Coed (21 & over) Division 5 (no standings, goal limit) |
|
[ ] |
Recreational Coed (21 & over) Division 6 (no standings, goal limit) |
Team Name:_____________________________________ Average age of team:___________
Manager's Name:_________________________________ Home Phone:(_____)_________________
Work Phone:(_____)____________________ e-mail: _______________________________________
Address:____________________________________________________________________________
City:__________________________________ State:______________ Zip:__________________
PREFERENCES: Please consider outdoor soccer, weddings, out-of
town tournaments, holiday weekends, etc.
Men's &
Preferred day(s): [circle]
SUN
MON
TUE
WED THU
Women's ---------------
Teams
Days to avoid (maximum of
two): SUN*
MON
TUE
WED THU
*note:
teams may have to play at least three Sunday games (9 AM +)
Coed
Preferred day(s): [circle]
SUN
MON
TUE
WED THU
Teams ---------------
Days to avoid (maximum of two):
SUN*
MON
TUE
WED THU
*note:
coed teams may have to play at least 2 Sunday games,
3 Saturday games, and 1 Friday game; Saturday and Sunday games
may start as early as 11:15 AM; Friday and Saturday games may start as late as
midnight:15.
Specific date to avoid (if possible):________________________________________________
FINAL CHECKLIST (Check each
item as you complete each task)
__ Did you select your preferred season?
__ Did you select the division you want to play in?
__ Did you enclose a check for $100?
__ Did you read the "important" information
on the previous page?
Mail or bring this form with
a $100.00 team deposit to:
PORTLAND INDOOR SOCCER, INC. Office use only
418 S.E. Main St.
Portland, OR 97214
Date deposit received: __________
(503) 231-6368
www.pdxindoorsoccer.com
Amount: _____________________