Futsal League
Team Registration Form
DATE: ________________ Team Name:_______________________________________________
COACH/REP:_______________________ ASST. COACH:________________________________
COACH/REP PHONE: (____)_____________ ASST. COACH PHONE: (____)________________
E-MAIL ADDRESS: ________________________________________________________________
TEAM REGISTRATION FEE: Adult Leagues - *$285.
*$25 discount applies to all teams that are PAID IN FULL prior to their first game or first
scheduled game of the new season. No Exceptions. All leagues fees must be paid in full by your
first game.
Adult Division (select one)
Mens Open – Womens Open – Co-Ed Open
D1_______ D1_______ D1_______ D1_______ D1_______
D2_______ D2_______ D2_______ D2_______ D2_______
D3_______ D3_______ D3_______ D3_______
Recreational_________ Competitive_________
A $100 deposit must be paid at the time of registration. Remaining fees must be paid in full prior to the start
of the first game.
To receive discount please refer to info above regarding league fees/payment info. Failure to pay all fees on
time will result in game forfeiture
Forfeiting team will pay referee fees for both teams. In addition, an official roster must be turned in prior to
the start of first game, and can be modified up to the third game.
COACH/MANAGER/TEAM REP SIGNATURE:_____________________________DATE:____________________
Payment Type
Paid Deposit
Cash
Check
Official Use Only
Paid in Full