Vineland Soccer Association

Adult Summer Soccer Application 2008

 

All players must be 18yrs of age or older!

           

Team Name:___________________________________________________________________

Head Coach:___________________________________________________________________

Home Phone Number:____________________________________________________________

Work Phone Number: _____________________________________________________

Cell Phone Number: (mandatory) ____________________________________________

Street Address:________________________________________________________________

City, State, Zip Code:___________________________________________________________

Email Address (mandatory):_______________________________________________________

 

 

Comments:  ___________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

 

I hereby submit my team and understand that, once my team has been accepted, no refunds will be given!

 

 

Coach Signature:      _________________________________     Date:  __________________

 

Application Must Be Received By May 18, 2007

 

$500.00 Per Team

Any Questions, Email Helmut Lackermayer at vsavp@comcast.net

 

 

 

Jersey Colors_________________________ Alternate _________________________________

 

 

o Check made payable to Vineland Soccer Association $500.00

o Completed Application, including email address

o 16 man roster

 

 

Mail to: 

Vineland Soccer Association

Adult Soccer

C/O Helmut Lackermayer

1902 West Main Street

Millville, NJ 08332