Online Tournament Application Form

2011 Henderson Tournament

Entry Deadline 11:59PM July 31st 2011
 Entry Fee : $400.00 CDN

Please supply a Fax Number and / or an e-mail where you can be reached.

Age Division : Born after Jan 1st, Type :
Full Team Name :
Club Name :
Team Colours
(Shirts / Shorts) :
Alternate Colours
(Shirts / Shorts) :
Coach's Name :
Manager's Name :
Address :
Address :
City :
City :
Province :
Province :
Postal (Zip) Code :
Postal (Zip) Code :
Home Phone :
Home Phone :
Work Phone :
Work Phone :
Fax :
Fax :
E-Mail :
E-Mail :
Send Tournament mail to :
I , and I of the team agree to abide by the rules of the Tournament and decisions of the Tournament Committee.
Please list curent (or last season's) record.
Year
Wins
Losses
Ties
League Affiliation :
Provincial or State Association :
Division Name (check all that apply) :
OYSL
Elite
Premier
First
Second
Third
League Registrar's Name :
League Registrar's Phone :
Club Secretary's Name :
Club Secretary's Phone :
Team League Record for Last 3 Seasons
Year
Wins
Losses
Ties
Tournaments entered and record (indicate position in Tournament and year)
Please list other teams you compete against in your division in the tournament year
Girls Convenor : Elaine Clemens
650 Railton Ave., London, ON N5V 4E7
tel : 519-659-7356

Boys Convenor : Tara Newton
51 Mendip Cres. London, ON N6E 1H2
tel : 519-204-2650


For inquiries contact the girls convenor Elaine Clemens at eaclemens@gmail.com or the boys convenor Tara Newton at biranifamily@rogers.com.

 

Please make / send all cheques payable to : London United Competitive Soccer Club
Mail cheque to appropriate convenor address listed above.