Please remember that you are not registered if payment does not accompany your registration.  To avoid confusion please do not submit registration forms that do not include payment.  If you do not want to send credit card information online, please register by fax, mail, or in person. 

We appreciate your cooperation!

Thanks!

  COACH            ASST. COACH
(check one if interested)

P O Box 5034 • Traverse City, MI  49696 • Phone: 933-8229 • Website: www.tbays.org

PLAYER INFORMATION

Player’s Last Name 	Player’s First Name 
Date Of Birth  	Sex  Male  Female
Address  City    Zip 
email address: 

PARENT/GUARDIAN INFORMATION
(Employment Info Requested For Alternate & Emergency Contact Purposes)

Mother’s Name    Home Phone  Work Phone 
Father’s Name    Home Phone  Work Phone 

	

	

TEAM ASSIGNMENT INFORMATION

Team /Coach 	1st Choice
Team /Coach 	2nd Choice


	
If your 1st choice team is full and you 
	leave your 2nd choice blank, we will assume that we can place you 
	on any team in your age group that has an opening.  If you don’t want that 
	to happen, please put ‘none’ on the 2nd choice line. There is no 
	waitlist so we encourage parents to put down two teams in case the first 
	team is full.  To get information about currently available teams and more 
	information about team selection, please check the Junior Rosters 
	on the website, Rosters.

	

	Please Select The Bracket That Matches Your Child’s Grade: 

			

	Please mail a completed Medical Release form to	
	P.O Box 5034, Traverse City MI 49696 
	in order to complete the registration.

	

	Fees & Payment

	
Registration 
	Fee before August 29, 2011 = $50

	
Registration 
	Fee after August 29, 2011 = $60

	
No 
	registrations will be accepted after Sept. 5, 2011

	
  Check here to order the optional Uniform for $15 (2 TBAYS T-Shirts 1 red, 1 white w/TBAYS logo)

	

	
	T-Shirt Size: 

REFUND POLICY

	

		
TBAYS will refund your Registration Fee up to the start of the season.

	

	

	There are NO refunds after that time.

	

Please fill out the credit card information below.  Online registrations MUST include payment information.

	


 VISA or  MASTERCARD    Exp. Dat  CVV Code 

	

		
 

	

	

		

		TALENT RELEASE AGREEMENT

		

		I hereby assign and grant to 
		Traverse Bay Area Youth Soccer the right and permission to use and 
		publish the photographs/film/videotapes/electronic representations 
		and/or sound recordings made of me or my child at any activities, and I 
		hereby release Traverse Bay Area Youth Soccer, the activity 
		coordinators, and all employees, volunteers, related parties, or other 
		organizations associated with the activity from any and all liability 
		from such use and publication.I hereby authorize the reproduction, sale, 
		copyright, exhibit, broadcast, electronic storage, and/or distribution 
		of said photographs/film/videotapes/electronic representations and/or 
		sound recordings without limitation at the discretion of Traverse Bay 
		Area Youth Soccer, and I specifically waive any right to any 
		compensation I may have for any of the foregoing.   
		Yes 
		No