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The East Bay Futsal League is a sanctioned member of the  United States Futsal Federation

 

 

REGISTER HERE & NOW TO PLAY IN THE  FIRST SESSION of the 2007-08 Season of Futsal  in East Bay Simply fill out this form online and press SUBMIT! It's that easy!
 

The Session:  T.B.A.
 

Day & Times to Play Futsal:  All games are set for Saturdays from 10 AM to 7 PM, dependent upon gymnasium availability & # of teams.
 
League is Sponsored by:
United State Futsal Federation, United States Futsal, The Rhode Association of Futsal

Team Registration: (not applicable for individual registration)

Team Name:
Select or Rec:   Age/Group:   Gender:  
 Coach's Name:
 Team Address:
City, State Zip: ,  
Home Phone:
(Proceed to Payment Area below)
 

Player Information: (not applicable for team registration)

 Name:
Current Team:
Select or Rec:   Age/Group:   Gender:  
Grade:   Age:   Gender:   Birth Date
 Address:
City, State Zip: ,  
Home Phone:

Parent  Information: (individual sign-up)

Father's Name:
Father's Email:
Work Phone:
Cell Phone:
 Mother's Name:
Mother's Email:
Work Phone:
Cell Phone:

Emergency Contact Information:

Contact Name:
 Phone:
Cell Phone:

Medical Conditions:

Known Allergies:
Medical Conditions:

Consent & Release Section:

Consent for Emergency Medical Aid and Medical Treatment
As the registrant or Parent/Legal Guardian of the above named registrant, I hereby give consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dental Medicine. This care may be given under whatever conditions are necessary to preserve life, limb, or well-being as deemed advisable in the event of an accident or illness during the soccer related activities in which we are voluntarily participating.  I , the participant or parent/guardian of a minor registrant, agree that the registrant and I will abide by the rules of the league, its affiliates and sponsors. Recognizing the possibility of physical injury associated with Futsal and in consideration for the League accepting the registrant for its Futsal  (5-A-SIDE / Indoor soccer) program and activities (the "Programs"), I hereby release, discharge, and/or indemnify the League, its affiliated organizations (if any) and sponsors, their employees and associated personnel, including the owners of gymnasiums and facilities utilized for the Programs, against any claim by or on behalf of the registrant as a result of the registrant's participation in the Programs and/or being transported to or from the same, which transportation I hereby authorize. Further, I hereby acknowledge that participation in athletic competitions, camps, and/or clinics carries with it certain potential hazards. In consideration for League accepting the registrant for its program, I further release, discharge and/or indemnify the diocesan schools, its officers, directors and employees, any coaches, assistant coaches and referees, the schools in which any such athletic activities are being physically conducted, the league with which I am affiliated, the organization permitting the institution/facility, and the institution/facility at which this activity is being conducted, against any claim by or on behalf of the registrant as a result of registrant's participation in the Futsal programs.

Parent / Legal Guardian Name:
Parent / Legal Guardian Signature:  
(if signing up online please type in name and last 4 digits of your social security number)
 

Payment Area:

I have paid / am paying $650. for a team or $75. for a player registration for the
I wish to purchase Baden Futsal Ball at a cost of $25.00 each
I wish to pay by check (fill out information below).
Payment being made:  (Please make payment payable to New England Futsal)
Mail to:  55 Glendale Rd . Tiverton . RI  02878
 Amount $:

State Shield

Check Date:
Check #:
   Thanks for registering with us.... All the Best!
 

 

   
 

FUTSAL® "five-a-side soccer"  The Official indoor Game of FIFA