Western Sports Mall
Registration Forms

Team Registration (Printable Form)

WESTERN SPORTS MALL
 SOCCER TEAM REGISTRATION

Mail to:
The Western Sports Mall
2323 Ferguson Road, Cincinnati, Ohio 45238
513-451-4900

Team Name/ Color________________________

Outdoor Organization________________________

Outdoor level of soccer played________________________

Age Group (see chart)_________ Check One: [ ] M  [ ] F  [ ] Co-ed

Coach Name: _______________________________________
Address: ___________________________________________
City/state/Zip: _______________________________________
Day Phone: _______________ Night Phone: _______________
Cell: ___________________  E-mail:_____________________

Field Choice, if applicable (Circle One)
1 = Small Field
2 = Large Field

Competition Level Preferred (Circle One)
A = Upper Level Select
B = Lower Level Select
C = Upper Level Recreational
D = Lower Level Recreational

Session:  (Circle One)
_       Fall                    Winter     _

Has the majority of this team played at Western Sports Mall in the past two years? _______
If yes, team/coach name and when played: _______________

Team Fee
See "Next Session", Dates, Deadlines, and Dollars by session. Minimum $150 non-refundable deposit, or payment in full, must accompany registration. Balance of league fee due the day of your second scheduled game. Deposit will only be returned if team cannot be scheduled into league.
Make checks payable to: Western Sports Mall

Note to Coach: You must collect a filled out individual registration/liability waiver for every rostered player and turn it in at the Western Sports Mall Soccer office before players can participate.

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