July 18th and 19th

Registration Deadline July 10, 2015 Tournament Director: Dan Hurt 937-515-2196

Or Email: beasteast3v3@gmail.com

Visit us on Facebook @ BeastOfTheEast3v3SoccerTournament2015

Location of event: Western Brown High School, 524 West Main Street, Mt. Orab, Ohio 45154

BEAST OF THE EAST 2015 / 3v3 SOCCER TOURNAMENT / REGISTRATION FORM

Team Name: Age Divisions (Please Mark)

Gender: Male Female Co-ed U6 Aug. 1, 2009 - July 31, 2010

Coachs Name: U7 Aug. 1, 2008 - July 31, 2009

Coachs Phone #: U8 Aug. 1, 2007 - July 31, 2008

Coachs Email: U9 Aug. 1, 2006 - July 31, 2007

Coachs Address: U10 Aug. 1, 2005 - July 31, 2006

U11 Aug. 1, 2004 - July 31, 2005

Please Mark(All Divisions) U12 Aug. 1, 2003 - July 31, 2004

Competitive Upper Lower Recreational U13/14 Aug. 1, 2001 - July 31, 2003

U15/16 Aug. 1, 2003 July 31, 2005

U17/18 Aug. 1, 2005 July 31, 2007

Adult 18 and over

Players

Player 1 Player 2 Player 3

Name:

Address:

Phone:

DOB Age Gender DOB Age Gender DOB Age Gender

Parent Signature:

Shirt Size* SM Med LG XL XXL SM Med LG XL XXL SM Med LG XL XXL

Player 4 Player 5

Name:

Address:

Phone:

DOB Age Gender DOB Age Gender

Parent Signature

Shirt Size* SM Med LG XL XXL SM Med LG XL XXL

* There will be an additional charge of $12.00 for each shirt PLEASE READ THIS CAREFULLY AND BE AWARE THAT IN SIGNING UP AND PARTICIPATION IN THIS TOURNAMENT, YOU WILL BE EXPRESSLY ASSUMING

THE RISK, LIABILITY, WAITING AND RELEASING ALL CLAIMS FROM INJURIES, DAMAGES OR LOSS YOU OR YOUR CHILD MIGHT SUSTAIN.

I DO HERBY FULLY RELEASE AND FOREVER DISCHARGE BEAST OF THE EAST SOCCER TOURNAMENT 2015, FORM ANY AND ALL CLAIMS FOR INJURIES, DAMAGES AND LOSS THAT MY CHILD OR I MAY HAVE OR WHICH MAY OCCUR TO ME OR MY CHILD AND ARISING OUT OF, CONNECTED WITH, OR IN ANY WAY ASSOCIATED WITH THIS TOURNAMENT.