Rock On! 3v3 Soccer Tournament

May 23 & 24, 2015

$160/Team (Adult Division)

Click inside the coloredbox followingthe request for informationand type your answer.

PLEASE COMPLETE ALL BOXES. Print to mail, or save to your computer to email.

Team Name: / Division (U19-O50):
(2014-2015 season) / U-
O- / Men / Women / Level of Play:
(Rec, Competitive)
Team Contact: / Home Phone: / Cell Phone:
Mailing Address:
Email Address (This is how we will contact you):
By my signature below, I do hereby assure the Rock On! 3v3 Soccer Tournament and North Whidbey Soccer Club that each player on this team’s roster agrees to abide by the Rock On! 3v3 Tournament rules, that each player can produce proof of age should it be requested at any time by tournament organizers, and that completed Medical Release and Concussion forms for each player will be provided to tournament organizers no later than check-in. I further agree, on behalf of each player on the team, that pictures taken may be used for future promotional purposes.Team Contact Signature
Players / First Name / Last Name / Date
of
Birth / Shirt
Size
(AS, AM, AL, AXL) / Jersey
# / NOTE:
Team registration fee includes $7.00 per player for mandatoryfield insurance for the weekend event.
PLAYER 1 / CompletedMedical Release and Concussion forms
for each player must accompany Team Registration Form
PLAYER 2
PLAYER 3
PLAYER 4
PLAYER 5

Register by MAIL and pay by CHECK:

Send completed form along with payment ($160 made out to NWSC)

and Medical Release and Concussion forms for each player to:

Rock On! 3v3/NWSC* Post Office Box 2896 * Oak Harbor, WA 98277

OR

Register by EMAIL and pay with PAYPAL:

From your Team Contact email, send completed form as an attachment to:.

A Paypal invoice for the registration fee will be sent within 24 hours.

Completed Medical Release and Concussion forms must be turned in at check-in.

Registration is not complete until we have received payment as well asMedical Release and Concussion forms for ALL participants. Proof of age for all players must be available upon request.

REGISTRATION DEADLINE:Friday, May 15, 2015

NO DOGS ALLOWED on Tournament grounds

2015 ROCK ON! AGE GROUPS
U19 / 5/24/95 / 7/31/96
O20 / 5/24/85 / 5/23/95
O30 / 5/24/75 / 5/23/85
O40 / 5/24/65 / 5/23/75
O50 / 5/24/45 / 5/23/65

* Adult teams

play to the

youngest player