Winter Indoor Soccer 3v3 - Team Registration Form
This indoor 3v3 League is designed to provide LSSA recreational and competitive Coaches the
opportunity to give their players additional soccer activities in the outdoor off season .
Please mail (or drop off at the UPS store) this form (2 pages) along with payment to:
LSSA Registrar, 705B SE Melody Lane, PMB 303, Lee’s Summit, MO 64063.
The deadline for submitting your Winter 3v3 Team Registration is November 3, 2012
Make checks payable to: “Lee’s Summit Soccer Association.”
Team Name for Fall 2012:__________________________Division for Fall 2012 ________________________
Team Age (actual): ___________________ Division for Winter 3v3 ____GOLD (comp) _____SILVER (rec)
(Your Team’s Age is determined by the team’s oldest player. Please list it per the following example: BU10. )
Team Head Coach:_________________________ Phone: ________________________________
Mobile: _______________________________
E-mail: ________________________________
Team Roster
Player name
Player date of birth
Please include payment of $40 per player with this form. Total $________________Check#___________
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Winter Indoor Soccer 3v3 - Team Registration Form
Winter 3v3 Details:
All games will be played at Z Sports Arena in Greenwood, MO
Only players on the approved roster will be allowed to participate in games. Players may only be listed on ONE
team roster for the season. Additional rules are posted on the website. WWW.LSSA.ORG
Team Registration Form:
Registration is done by a team (not by individual player). Coaches must submit player roster and payment at
the time of registration, along with signed participation waivers from parents of all participants on the roster.
Program is open to all LSSA Coaches from Fall 2012 and Spring 2012 outdoor soccer seasons. Team
Registration Fee will be $40.00 per player on the roster.
Refund requests for teams will be considered if requested up to two weeks before the opening weekend. No
refunds after the schedules are posted.
A limited number of teams will be accepted, subject to field availability & other considerations. Depending on
the number and age divisions of the teams that register, age brackets may be combined plus or minus a single
age in order to complete a scheduling bracket. For example, LSSA may have a U7/U8 age bracket. Likewise,
we may have to for coed brackets for some age divisions.
Scheduling:
Every effort is made to allow adequate time between games for coaches that are listed as the head coach on
multiple teams. Games will be scheduled between the hours of 8:00 am and 8:00 pm. Games will be played
Dec.1, 8, and 15, and Jan. 5, 12, 19, 26. (no games will be played on Dec. 22 or Dec. 29. Schedules will be
posted two weeks before the first game. There will be a tournament on Feb. 2, and medals will be awarded to
the top two teams in each bracket.
Forms Needed:
Coaches must submit information for background check if status is expired (once per twelve months).
Additionally, parent or guardian of players must sign Indoor 3v3 Waiver in order to participate. Coaches
should include these signed waiver forms for each player with the paid team registration. If you need
assistance, please contact the Registrar at LSSA at [email protected]. The required forms can be found at
www.lssa.org.
Head Coach Signature________________________________________________date_________________
By submitting this application, I state that I have read and understand the Rules for Indoor 3v3 Winter
League Soccer listed above and any Rules posted at www.lssa.org.
Office Use only: rec'd by/ date:
check #
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check amount $