CIASA Team Registration

Central Indiana Amateur Soccer Association

CIASA TEAM REGISTRATION FORM
Registration Year/Season *
Team Information *

Team Name Division Requested Prior Season Division (if any)
Team Manager/Coach *

First Name Last Name Phone Number
Team Manager's Email Address *
example@example.com
Team Manager/Coach's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
2nd Team contact Information

First Name Last Name Phone Number
2nd Optional Email Address
example@example.com
Team Jersey Home Color *
Team Jersey Away Color Color *
Team Bond is $320
Existing teams must verify/make sure their deficit is paid - All teams must be in good standing with their Bond Account
Team Registration is $450 *
Teams who attend the General Meeting will pay only $300
Our Home Filed will be:
Amount Owed CIASA Is: *
Today's Date

Month Day Year
Additional Comments for consideration
Signature

Clear
Should be Empty:

Central Indiana Amateur Soccer Association