Application Form for Portage Soccer Classic Application June 15-16, 2002

Directions:

1. Print this form using your computer's printer. For proper print formatting of this application, please set your view text on your browser to medium. Fill out application completely, including FULL addresses and phone/fax numbers. Please print or type.

2. Attach a copy of your official team roster with players' names and birthdates. Signatures are not required at this time; a final roster with signatures will be required at check-in on Friday, June 14, 2002.

3. Include tournament entry fee of $325 (U.S.) (Lower fee if postmarked by March 15, 2002) U11 thru U19 and $275 (U.S.) for U10 teams with application. Make check payable to "Portage Soccer Classic"

4. Return application form and check to Portage Soccer Classic, P.O. Box 2257, Portage, MI 49081, as soon as possible, but no later than April 30, 2002. After March 15, the tournament entry fee is $325.

An acknowledgment letter or postcard will be mailed to you as soon as we receive your application materials. If requested, a housing information sheet will be included. Acceptance letters and additional information will be mailed prior to May 15, 2002. If you are not a Michigan team, be sure to submit an "Application to Travel" form to your state organization at least 30 days prior to the tournament.

Team Information:

Age Division Preference:   ________ Boys   ________ Girls (no U15 or U17 girls division)

______U10   ______U11   ______ U12   _____U13   _____U14   _____U15   ______U16   ______U17   ______U19

(Note: Final placement for teams requesting to play up is not guaranteed. All players must meet the age requirement of the division.)

Birthdate of oldest player: ______________________

Competition Level:   _____Recreational   _____Club   _____Premier

Team Name:______________________________________ Hometown:__________________________________

Jersey Color(s):____________________ Alternate Jersey Color(s):____________________

League:______________________________________ Club Affiliation:__________________________________

League Registrar:_________________________________ Phone: ( _____ ) ____________________________

Address (Street, City, State, Zip):________________________________________________________________________

____________________________________________________________________________________________________

Coach:_____________________________ Phone: ( _____ ) __________________

Address (Street, City, State, Zip):__________________________________________

_____________________________________________________

League Manager:___________________________ Phone: ( _____ ) __________________

Address (Street, City, State, Zip):__________________________________________

_____________________________________________________

Send information to: ______Coach   ______Manager

Send housing information? ______ Yes   ______ No

*Fax Number:___________________________ To Whose Attention?_____________________

(*All Canadian teams must provide a Fax number!)

League record for the past three seasons:

2001:___________________ 2000:______________ 1999:________________

Tournaments entered in 2001 and team record:

___________________________________________________________

___________________________________________________________

___________________________________________________________

Has this team played in previous Portage Invitationals? ______01  ______00   ______99   ______98   ______ Prior

Has this coach been to previous Portage Invitationals? ______01  ______00   ______99   ______98   ______ Prior

I,__________________________, the coach/manager of ____________________________ assure that the information given above is accurate and agree on the behalf of the team I represent to abide by all USYSA, MSYSA, and Portage Invitational Soccer Tournament rules and regulations. I understand that there can be no refunds after teams are accepted for participation.

Signature:_________________________________ Date:_________________

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