Hass Attack 3v3 Soccer Tournament Application - DOC by TWPC5Ja

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									                                 Hass Attack 3v3 Soccer
                                 Tournament Application

     Coach’s Name: _____________________Phone__________
     Address:     ___________________________________
     Email Address: __________________________Age: U-___
     Team Name: ___________________Level (Highest-1) 1 2 3

     Players:
     Name:     ____________________DOB:______________
     Signature (Parent’s if under 18)______________________

     Name:     ____________________DOB:______________
     Signature (Parent’s if under 18)______________________

     Name:     ____________________DOB:______________
     Signature (Parent’s if under 18)______________________

     Name:     ____________________DOB:______________
     Signature (Parent’s if under 18)______________________

     Name:     ____________________DOB:______________
     Signature (Parent’s if under 18)______________________

    By signing the above, you recognize the possibility of physical injury associated with
soccer and hereby release, discharge, and/or otherwise indemnify the Cedar Crest High
School, its sponsors, their tournament committee, board members, employees, and
associated personnel against any claims by on behalf of the registrant as a result of the
registrant’s participation in this tournament, and/or being transported to or from the same.


             Checks payable to: Johnny Hassinger Benefit Fund
                             Mail checks and application to:
                                    Daryl Neiswender
                                   20 Boxwood Drive
                                   Lebanon, PA 17042

								
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