Dewitt Ox Roast 4x4 Soccer Tournament
Registration Form

NOTE: This form is to be PRINTED and MAILED to the address below. Original signatures of players and parents are REQUIRED.

Team Information

Team Name:  
* A name will be assigned if left blank.

Division:  

   Age Group:  
            • Please check the appropriate age division according to the OLDEST player on the team.
            • Age as of July 31, 2008 (Example: If you are 12 on July 31, 2008, you play U-13 – there will be NO EXCEPTIONS).
            • All players must be prepared to show  proof of age upon request (copy of birth certificate or driver’s license).
            • If there are not enough teams in a division, you will be put in a division at the discretion of the soccer committee.
            • Please wear coordinated team shirts.
            • NOTE: Boys High School Soccer players are ineligible due to MHSAA rules.

Captain Information

Captain's Name:  

Street Address:  

 City:  

State:  

          Zip Code:            Phone No:  

Date Of Birth:  

          Sex:   Male Female

T-Shirt Size:  

 Youth: Large                Adult: Small Medium Large X-Large

Parent/Guardian* Signature:
(Player signature, if over 18 years of age)

 __________________________________________ Must be ORIGINAL Signature

Player 2 Information

Player's Name:  

Street Address:  

 City:  

State:  

          Zip Code:            Phone No:  

Date Of Birth:  

          Sex:   Male Female

T-Shirt Size:  

 Youth: Large                Adult: Small Medium Large X-Large

Parent/Guardian* Signature:
(Player signature, if over 18 years of age)

 __________________________________________ Must be ORIGINAL Signature

Player 3 Information

Player's Name:  

Street Address:  

 City:  

State:  

          Zip Code:            Phone No:  

Date Of Birth:  

          Sex:   Male Female

T-Shirt Size:  

 Youth: Large                Adult: Small Medium Large X-Large

Parent/Guardian* Signature:
(Player signature, if over 18 years of age)

 __________________________________________ Must be ORIGINAL Signature

 

 

 

 

 

 

Player 4 Information

Player's Name:  

Street Address:  

 City:  

State:  

          Zip Code:            Phone No:  

Date Of Birth:  

          Sex:   Male Female

T-Shirt Size:  

 Youth: Large                Adult: Small Medium Large X-Large

Parent/Guardian* Signature:
(Player signature, if over 18 years of age)

 __________________________________________ Must be ORIGINAL Signature

Player 5 Information

Player's Name:  

Street Address:  

 City:  

State:  

          Zip Code:            Phone No:  

Date Of Birth:  

          Sex:   Male Female

T-Shirt Size:  

 Youth: Large                Adult: Small Medium Large X-Large

Parent/Guardian* Signature:
(Player signature, if over 18 years of age)

 __________________________________________ Must be ORIGINAL Signature

If any of the above-listed players will be participating in the Ox Roast Parade, please indicate here _________.

*NOTE:  Parent/Guardian must read waiver**
**Waiver: Every player and their parent or guardian, if player is under 18, must read and sign this waiver form. Signatures on the registration form signify that each person has read, understands and abides by this information. I understand there are risks connected with any participation in this tournament and its related activities. I release and discharge the DeWitt Soccer Club, event sponsors, organizers, workers, employees and directors from all action, suits and demands whatsoever, in law or in equity, including but not limited to, the risk of injury from playing in this tournament and the risk of loss of personal property by theft or otherwise. Further, I hereby grant full permission for event organizers to record any or all of my participation in this event for photos, TV, radio, videotapes, and to use them for publicity, promotion or advertising for the DeWitt Soccer Club and its events sponsors and its organizers, without any reimbursement of any kind due to me or the need to pay me any fee. Excessive fouls, rough play or dissension will not be tolerated. We reserve the right to eject any player, coach or spectator for improper play or misconduct.

For more information call 517-669-9466 or email 4x4@dewittsoccer.org.
For a complete set of rules or additional information, please visit our web site at: www.dewittsoccer.org
Mail checks or money order along with this form to:  DeWitt Soccer Club, P.O. Box 644, DeWitt, MI 48820

OFFICIAL USE ONLY:
DATE:______________    DIVISION:______________    TEAM NO:______________    PAYMENT: $______________