APPLICATION FOR THE 18TH ANNUAL

DILLSBURG DUAL SHOOTOUT
Soccer Tournament
October 9 & 10, 2010

Team Name
Age Group: Based on August 1, 2010 date of birth.			Girls U09 Girls U10 Girls U11 Girls U12 Girls U13 Girls U14 Boys U09 Boys U10 Boys U11 Boys U12 Boys U13 Boys U14
Team's record for last season.
If a New Team and you have no record, pick YES. No Yes	Wins	Losses	Ties
Current level of soccer you are playing at in your league. Division 1, 2, or 3/ Division 1 being most competitive.			1 2 3
My team is willing to play in the next higher age group.			No Yes
Soccer Club Affiliation
Soccer League Affiliation	CPYSL BMYS BBSL CCTL CL CMSSL CVGSL CSL DELCO HCSL ICSL IGYSL LANCO LIJSL LVYSL MASL MPSL MSL NCPYSL NCSL NETSL NEYSL OBSL PAGS RBJSL RSL SJGSL SJSL SLSL SPSL UBSL UJSL WAGS WPSL YUSA OTHER
State Soccer Association	EPYSA      Eastern Pennsylvania Youth Soccer Association ENYSSA     Eastern New York Soccer Association DYSA      Delaware Youth Soccer Association MSYSA      Maryland State Youth Soccer Association NJYSA      New Jersey Youth Soccer Association PAWEST     Pennsylvania Western Association USCS      US Club Soccer VYSA       Virginia Youth Soccer Association WVYSA      West Virginia Youth Soccer Association OTHER
Contact Name
Street Address
City
State
Postal Code
Phone format: (999)999-9999	() -
E-mail address