PARTICIPANT/PLAYER REGISTRATION FORM

VIVA LA SOCCER TOURNAMENT

REGISTRATION DETAILS
Male Female
First Name: ............................................................................ Last Name: ..........................................................................
Team Name:........................................................................... Division: ................................................................................
Age.........................................................................................
Address: .................................................................................................................................................................................
Zip code:..............................Town:......................................... Country:.................................................................................
Phone:.................................................................................... Email:.....................................................................................
Emergency Contact 1:
Name: .................................................................................... Phone: ..................................................................................
Alt. Phone:..............................................................................
Emergency Contact 2:
Name: .................................................................................... Phone: ..................................................................................
Alt. Phone:..............................................................................

EVENT DETAILS BY DATE & HOUR

Dates Hours
June 18 8am-6pm
June 19 8am-6pm
June 20 8am-6pm
June 21 8am-6pm
OVER ALL EVENT DETAILS
EVENT NAME Viva La Soccer Tournament DATE OF EVENT June 18 - June 21
ACTUAL TIME OF BEGIN: June 18 @ 8am LOCATION: Elizabethtown Sports Park
EVENT END: June 21 @ 6pm 1401 West Park Road
Elizabethtown, KY 42701

Parent/Guardian Signature Date

Player Signature Date