2017 FSIN Youth Championship
Registration/Roster Form
Team Name:
City:
Age/Gender Category:
Member TC:
Team Colors (Home Shirt/Shorts):
Team Colors (Away Shirt/Shorts):
Head Coach
First and Last Name
Certification/NCCP
Number
Respect in Sport
Number
Email Address
Phone Number
Assistant Coach
First and Last Name
Certification/NCCP
Number
Respect in Sport
Number
Email Address
Phone Number
Manager
First and Last Name
Certification/NCCP
Number
Respect in Sport
Number
Email Address
Phone Number
$150 per
Team
Deadline:
June 9, 2017
Rosters not completed in full
will not be accepted.
One roster form per team must
be submitted.
Mail Cheque to:
Saskatchewan Soccer
1870 Lorne St.
Regina, SK
S4P 2L7
Submit Electronic Form to:
[email protected]
Players First Name
Players Last Name
Address
Birth Date
M/F
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
The Maximum Roster Size for U12 Team is 14 Players
The Maximum Roster Size for U14, U16 and U18 Teams is 18 Players
By typing above I hereby declare that all of the above players and coaches are registered members of the above named member and that all players listed above are only
playing on the above listed team. If a player is later found to be playing or registered on two teams at the same time without the proper transfer papers submitted then
the entire team, including coaches and team personnel as well as the Member Organization and Entity whom they represent will be subject to discipline as outlined in
Section Four of the SSA Policy Manual. Discipline may include forfeiting of games during the Provincial Championships, suspensions, fines or other sanctions
*Photographs or Video will be taken by the SSA Staff at the SSA Sanctioned Event. Players, coaches and training staff give the SSA the right to use their image on the
SSA website (www.sasksoccer.com) and Social Media (Facebook, Twitter, etc.) in SSA publications and promotions. The photos may be cropped as or altered as
necessary to fit website format or publication formatting. All images will be the property of the SSA, and the SSA reserves the right of publication of all submitted
images in SSA announcements electronic media, and promotional material.
COACH’S SIGNATURE:
MANAGER’S SIGNATURE:
OFFICE USE ONLY
DATE RECEIVED:
PAYMENT: