NLS TEAM REGISTRATION FORM
NXTLVL SOCCER
TEAM NAME
TEAM HOME COLOUR
LOGO
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AGE DIVISION
Please Select
2015-16
2013-14
2012
2011
2009-10
2008-09
Contact Person
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Players
*
Coach Name
First Name
Last Name
Coach Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
By signing this form, you affirm that all the information herein is true and correct to the best of your knowledge. Any false information or misrepresentation that shall be found may cause the disqualification of such individual and penalty may be incurred against the team.
Coach or Representative's Signature
Name of Signatory
First Name
Last Name
Date Signed
-
Month
-
Day
Year
Date
My Products
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( X )
7V7
$
3,000.00
CAD
7V72 20 MINUTE HALVES REFEREE FEES INCLUDED
9V9
$
3,500.00
CAD
2 20 MINUTE HALVES REFEREE FEES INCLUDED
JERSEY WITH FRONT LOGO AND BACK NUMBER
$
20.00
CAD
ORDER YOUR TEAM JERSEYS DIRECTLY THROUGH NLS AS WELL
Quantity
1
2
3
4
5
6
7
8
9
10
Color
Red
Blue
Green
Yellow
Magenta
BLACK
WHITE
SILVER
GREY
Total
$
0.00
CAD
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