APPLICATION FOR ENTRY
PIERCE SOCCER ASSOCIATION TOURNAMENT

JUNE 13,14,15  2008

The entry fee is $100 for U8. The entry fee is $200 for U9 and U10. The entry fee is $240 for U11, U12, U13, U14. Please make check payable to Pierce Soccer Association. Applications will not be accepted without payment.

WAIVER OF LIABILITY

    I, the undersigned representative of the above team do agree to release, indemnify and hold harmless Pierce Soccer Association, officials, sponsors, coaches, referees, and/or other representatives from any claims arising out of any injury to the named participants on this team. I also certify that every parent has signed a release and permission form indicating that their child is physically fit and has their parent's permission to take part in these games.

SIGNED _______________________

PRINT NAME __________________

DATE _________________________

Mail this form together with the team roster and entry fee before May 15, 2008 to Kelly Eddy, President, 517 S. Lewis, Pierce, NE  68767.  Phone (402)329-4765. If there is not a minimum of three teams to have a division, the Pierce Soccer Association is given the discretion to either combine divisions or to refund the entire entry fee. However, the entire entry fee is forfeited in the event a team is accepted but does not attend.

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