EmailMe Form - Ohio North Youth Soccer Association: OUT-Team Form

This form must be completed by all teams requesting permission to participate in league play within a state association other than the state in which they reside. It is the responsibility of the team and coach/manager to submit the form to the appropriate parties within both the releasing and accepting state associations.

Team Contact *

First Last

Team Name *

Head Coach Name *

League: *

League Contact Person

Gender *

Age Division *

Contact Email *

Confirm

Contact Phone # *

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

Please include the phone number where you can best be reached during Ohio North office hours, 8-4 Monday through Friday.

Out of State Request Summary

Please let us know why you are requesting out-of-state permission below.

Type of Request *

Interstate Permission (registered in one state but team wishes to participate in league play in another state association)

Home State Office *

Accepting State: *

State team wishes to particpate in

Seasonal Year *

OHIO NORTH PAYMENT

Registration/Out of state fees: $25/team

Choice *

Out of State Team Permission $25

Payment will be sent via: *

Charge Card through Authorize.net: I will pay with a Credit Card through Authorize.net right now. (please note that after form is submitted, you will automatically be redirected to a payment screen.)

Check: I will print the order summary page and send in a check: made payable to OYSAN / 6650 W Snowville Rd Suite Y Brecksville, OH 44141

OHIO APPROVAL

*To be filled out by OHIO NORTH STAFF ONLY. *

OHIO NORTH APPROVAL STATUS:

Approved

Un-approved

OHIO NORTH NOTES TO ACCEPTING STATE:

Payment Status

Received by OHIO NORTH

Approval from accepting state received: