Team Registration - Session 1 2021

Winter 2021-22 Session #1 Registration
USL Division (PA West D5 / D6) or MLS Division (PA West D3 / D4)

Registration Extended Through Oct. 29th, 2021
Six week, six game session from November 6th - December 19th. No games Thanksgiving weekend Nov. 27th - 28th.

All games are Saturdays for U13 (Birth Year 2009) and up, Sundays for U12 (Birth Year 2010) and under.

East league games will be played and Pro Sports Monroeville or PISA Harmarville

North league games will be played at PISA Harmarville or Pine Richland Youth Center
Team Name*
League Location*

East: Pro Sports Monroeville and PISANorth: PISA and Pine Richland Youth Center
Preferred Division*

Recreational - Least Competitive (PA West D5 / D6 Equivalent)Competitive B - Moderately Competitive (PA West D3 / D4 Equivalent)Competitive A - Most Competitive (PA West D1 / D2 or Regional League Equivalent)
**Total Futal may ask for flexibility in location or division placement based on the final number of teams in each age group**
Soccer Club / Team*
Age Group (Fall 2021)*
Team Type*

BoysGirls
Bye Week Requests (2 Maximum - Please only use if needed)

Weekend 1: Nov 6th - 7thWeekend 2: Nov 13th - 14thWeekend 3: Nov 20th - 21stWeekend 4: Dec 4th - 5thWeekend 5: Dec 11th - 12thWeekend 6: Dec 18th - 19th
Comments / Special Considerations
Team Manager - Contact Information
Team Manager*

First NameLast Name
Team Manager Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Manager Phone*

Area CodePhone Number
Manager Email*
Is your Team Manager also a Team Coach?

YesNo
Team Coaches

All game coaches must be in compliance with the PA West Risk Management Policy including background checks and clearances on file with PA West. All teams must have an adult coach on the bench for every game. **Due to COVID-19 requirements, teams will likely be limited to ONE COACH on the bench for the 2020 - 2021 season.**
Primary Coach*

First NameLast Name
Primary Coach Email*
example@example.com
Primary Coach Phone*

Area CodePhone Number
Do you have additional coaches?

YesNo

Are all coaches in compliance with the PA West Risk Management Policy?*

YesI'm not sure
All coaches must be in compliance with the PA West Risk Management Policy and must have all required background checks and clearances on file with the PA West State Office. For more information on the specific requirements please visit: http://www.pawest-soccer.org/coaching/risk_management/

**All 2021 - 2022 PA West outdoor coaches will already meet this requirement and do not have to do anything additional for the futsal season**
Registration Type & Payment (Note: Referee fees are paid in cash prior to each game)
Payment Type*

PayPal or Credit CardCheck
PayPal or Credit Card Registration
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Full Season: U10 - U19$600.00

Full Season - U8 Age Group$500.00

Registration Minimum Payment$100.00
Check Registration

Full Season: U10 - U19 $600Full Season: U8 Age Group $500Registration Minimum Payment $100
Team Roster - 8 Players Recommended (6 min / 12 max)
Full names of all players are required for PA West / USFF rosters for the 2020 - 2021 season. You will have the option to add / change / drop players as part of the player waiver process prior to your first game.
Player 1 Name*

First NameLast Name
Player 1 Email
Player 2 Name*

First NameLast Name
Player 2 Email
Player 3 Name*

First NameLast Name
Player 3 Email
Player 4 Name*

First NameLast Name
Player 4 Email
Player 5 Name*

First NameLast Name
Player 5 Email
Player 6 Name*

First NameLast Name
Player 6 Email
Player 7 Name

First NameLast Name
Player 7 Email
Player 8 Name

First NameLast Name
Player 8 Email
Player 9 Name

First NameLast Name
Player 9 Email
Player 10 Name

First NameLast Name
Player 10 Email
Player 11 Name

First NameLast Name
Player 11 Email
Player 12 Name

First NameLast Name
Player 12 Email
Should be Empty:

	First Name	Last Name	Email Address	Phone #
Assistant Coach #1
Assistant Coach #2

Winter 2021-22 Session #1 Registration

USL Division (PA West D5 / D6) or MLS Division (PA West D3 / D4)

Team Manager - Contact Information

Team Coaches

Registration Type & Payment (Note: Referee fees are paid in cash prior to each game)

Team Roster - 8 Players Recommended (6 min / 12 max)