PLEASE PRINT THIS FORM.

 

THIS FORM MUST BE COMPLETED IN FULL

INCLUDE CHECK OR CREDIT CARD INFORMATION AND MAIL TO:

 

EVERETT SOCCER ARENA

2201 CALIFORNIA ST.

EVERETT,  WA  98201

OR

FAX  (425)339-8512

 

 

Text Box: SEASON_____________________ DIVISION___________________ DATE_________ TEAM NAME______________________________TEAM YEAR (youth divisions only) ________ TEAM MANAGER________________________________________________________ ADDRESS_____________________________ CITY___________________ZIP_______ EVENING PHONE______________________ DAY PHONE______________________ EMAIL____________________________ MASTERCARD OR VISA CREDIT CARD #________________________________________________________ EXPIRATION DATE____________________________ AMOUNT $______________________________________ BY SIGNING BELOW, I AUTHORIZE THE AMOUNT TO BE CHARGED TO CARD LISTED ABOVE SIGNATURE__________________________________________________________________