EmailMe Form - 2013 OYSAN State Cup Team Entry Form

TEAM INFORMATION

Select Your Age Group: *

Team Name: *

Club Name: *

League: *

Jersey Color: *

Alt Jersey Color: *

Coach's Name *

First Last

Coach's Cell Phone: *

### - ### - ####

Coach's Email: *

Coach's License *

If "Other" was selected in Coach's License
PLEASE SPECIFY:

Number of Years Team Has Played in State Cup: *

Last Year's Record: *

Wins: *

Ties: *

Losses: *

PRIMARY TEAM CONTACT

This person will serve as the primary contact for all future communications. Please be sure to enter CORRECT information.

Team Contact: *

First Last

Role with Team: *

Team Contact Email: *

Confirm Email

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Team Contact Home #: *

### - ### - ####

Team Contact Mobile #: *

### - ### - ####

Would you like to receieve Text Message alerts on the Team Contact Mobile? *

Yes

No

This includes game changes and game scores entered for your division.

If Yes, then select the Mobile Phone Provider:

TEAM PERFORMANCE HISTORY

Although not required, the information requested below helps the commitee in the selection and seeding process.

Fall 2012 League:

Division:

Wins:

Ties:

Losses

Spring 2012 League:

Division:

Wins:

Ties:

Losses

Additional comments:

List any info which will assist the selection sommitee in a proper evaluation. (Max of 250 Characters)

TERMS AGREEMENT: *

Check the box to agree with the below

I am entering the team named in this application the full understanding that all games in this competition will be governed by the following rules and in the following priority: (1) the OYSAN Directives, Rules and Regulations of the Competition as midified from time to time by OYSAN State Cup Chairperson, State Cup Chair Designees or State Cup Commitee, with or without notice, (2) the Rules, Regulations and the constituion of OYSAN, (3) the rules as determined by US Youth Soccer, and (4) the FIFA Laws of the Games. I, further understand, that the $575 team application fee is non-refundable. I understand that the rules/provisions of the OYSAN State Cup Tournament are subject to change with or without notice.

I also understand that any and all OYSAN State Cup materials (e.g., schedules, maps, standings, etc) will not be sent via US Mail. All pertinent OYSAN State Cup materials and information will be emailed to each team coach or team contact and all OYSAN State Cup materials and information will be posted on the OYSAN State Cup website at www.oysan.org.

ACCURATE AGREEMENT *

Check the box to agree with the below

I CERTIFY THIS APPLICATION IS ACCURATE AND COMPLETE.

SUBMISSION & PAYMENT INFORMATION

Once you press "SUBMIT APPLICATION" below, your application will be sent in for the 2013 OYSAN State Cup and will redirect you to the PayPal payment screen. Your form will not process if you do not enter valid payment at that time and fail to check the verification boxes above.