KASI Team Registration Form

 

Team Name_______________________________________________________

Region Number and City*___________________________________________

 

* This is how you will be listed on the KASI Tee Shirts

 

Age Division - Circle One

 

U10 GIRLS     U10 BOYS     U12 GIRLS    U16-19 COED

  

U12 BOYS     U14 GIRLS     U14 BOYS

 

Coaches name__________________________________________________________

 

Daytime Phone_____________________________________

 

Evening Phone_____________________________________

 

Address______________________________________________ ZIP________________

 

Email Address___________________________________________________

 

Alternate Contact Information:

 

Name__________________________________________________________

 

Phone_______________________________________________

  

Checks Payable to: AYSO REGION 211

 

Mail to:   AYSO/KASI

    6186 Ascot Ct.

    Kalamazoo, MI 49009

 

Entry Fee must be submitted with entry form.