KACHINA KLASSIC/SAFE HAVEN TOURNAMENT

2000 TEAM APPLICATION FORM

MAIL YOUR $275.00 REGISTRATION FEE, $150.00 REFEREE DEPOSIT ($425.00) AND COPY OF CERTIFICATE STATING YOU COMPLETED COACHES SAFE HAVEN. NO LATER THAN FEBURARY 10, 2000 TO:

KAREN RITCHIE

C/O KACHINA KLASSIC

1252 W. KIVA AVE.

MESA, AZ 85202

(PLEASE MAKE CHECKS PAYABLE TO: DASL (DOBSON AREA SOCCER LEAGUE)

AYSO REGION#_____________ COMMUNITY____________

BOYS TEAM_____GIRLS_______AGE GROUP_________

(U19,U16,U14,U12ORU10)

TEAM NAME__________________TEAM COLORS_______________

ALTERNATE JERSEYS (CIRCLE ONE) YES NO

COACHES NAME:________________________________________

ADDRESS:______________________________________________

______________________________________________________

TELEPHONE HOME: ( ) -

TELEPHONE WORK: ( ) -

TEAM CONTACT_________________________________________

TELEPHONE HOME: ( ) -

TELEPHONE WORK: ( ) -

PLEASE NOTE: WE NEED THIS FORM IN ADDITION TO THE TEAM ROSTER FOR EACH TEAM YOU WISH TO ENTER(DUPLICATE FORMS AS NEEDED)