SOCCER
SESSION (circle one):	SESSION 1	SESSION 2	SESSION 3
GROUP (circle one):	BOYS	GIRLS
TYPE (circle one):	5 on 5	6 on 6
AGE GROUP:	U-__________________________________________
TEAM NAME:	_____________________________________________
COLOR:	_____________________________________________
COACH'S NAME:	_____________________________________________
STREET ADDRESS	_____________________________________________
CITY, STATE, ZIP CODE	_____________________________________________
PHONE (day)	_____________________________________________
PHONE (evening)	_____________________________________________
E-MAIL	_____________________________________________
INDIVIDUAL REGISTRATION:	_____________________________________________
CHILD'S NAME:	_____________________________________________
DATE OF BIRTH:	_____________________________________________
PARENT'S NAME:	_____________________________________________
PHONE NUMBER:	_____________________________________________
E-MAIL:	_____________________________________________
LEAGUE FEE:	$_________

To register, print and fill out form and mail with payment to:
The Fairfax Sportsplex
6800 Commercial Drive
Springfield, VA 22151

The Fairfax Sportsplex reserves the right to change dates and times of leagues or to cancel games.
The Fairfax Sportsplex reserves the right to establish conduct and other rules and to terminate teams and individuals without fee reimbursement.