London, England   -   T B D

 Registration Form

PLAYER INFORMATION

First Name:      Last Name:

Street Address:

City:      State:      Zip:

Day Phone:      Evening Phone:

E-Mail:

UNIFORM/TEAM INFORMATION

Jersey Size: Small Medium Large X-Large Pick One      Short Size: Small Medium Large X-Large Pick One

Preferred Uniform Number:      Second Choice Uniform Number:
Numbers will be assigned on a first-come first-served basic

Soccer Experience: 

Position I'd Like to Play: Forward Midfield Defender Goalie Pick One      Are You: Right Footed Left Footed Pick One

Roommate Request:
Is there another player traveling that you want to play with

Do you want a Single Room: No Yes
Single rooms are VERY limited and will have a surcharge added to your cost. We will contact you if one is available.

Roommate Preference: Non-Smoking Smoking

Name of Non-Playing Travel Partner:

Teammate Request:
Is there another player traveling that you want to play with.

PAYMENT INFORMATION

          Play & Stay Vacation PLAYER Price:             $1499.45 per person
          Play & Stay Vacation NON-PLAYER Price:   $  999.45 per person

Payment Type: Pick a Form of Payment I'll Mail a Check Visa MasterCard Discover American Express

Payment Amount: Minimum $500.00 per person Deposit

Credit Card Number: Expiration: /

I am a client of Metro Adult Soccer and hereby appoint them to be my attorney in fact for the signing of documents necessary to purchase the above Play & Stay Vacation package and to charge the above amount to the credit card listed on this form. I also understand that if I cancel the above  mentioned package there are penalties, I have read the terms & conditions and UNDERSTAND them and agree to them.

Click here to confirm your electronic signature

Make Checks Payable to: METRO ADULT SOCCER

Mail checks to: Metro Adult Soccer, P. O. Box 15356, Riverside RI 02915