Registration Form

Baltimore International Soccer Academy presents the
4v4 BISA Cup Tournament Entry Form
Saturday, August 1, 2015
Herring Run Park
Entry Fee
Maximum of 6 co-ed players per team. Three game guarantee.
Early Registration Fee per team is $160. Registration deadline is June 18, 2015.
Regular Registration Fee per team is $180. Registration deadline is July 18, 2015.
Entry form and roster must be sent with fee by deadline.
Please make checks and money orders payable to: Baltimore International Soccer Academy
General Information
Games will be played on grass fields at Herring Run Park.
Duration of games is two 10 minute halves.
Tournament rules and game schedule will be emailed once your team is completely registered.
All schedules and rules will be posted on www.baltimoreintsocceracademy.com/4v4tournament.html.
50% refund will be given if team withdraws on/before July 18th. No refunds after July 18th.
For further information, please call 443-983-8228 or e-mail [email protected].
Divisions
January
February
March
April
May
June
July
August
September
October
November
December
2011
U6
U6
U6
U6
U6
U6
U6
U6
U6
U6
U6
U6
2010
U6
U6
U6
U6
U6
U6
U6
U6
U6
U6
U6
U6
2009
U6
U6
U6
U6
U6
U6
U6
U8
U8
U8
U8
U8
2008
U8
U8
U8
U8
U8
U8
U8
U8
U8
U8
U8
U8
2007
U8
U8
U8
U8
U8
U8
U8
U8
U8
U8
U8
U8
2006
U10
U10
U10
U10
U10
U10
U10
U10
U10
U10
U10
U10
2005
U10
U10
U10
U10
U10
U10
U10
U10
U10
U10
U10
U10
2004
U12
U12
U12
U12
U12
U12
U12
U10
U10
U10
U10
U10
2003
U12
U12
U12
U12
U12
U12
U12
U12
U12
U12
U12
U12
2002
U14
U14
U14
U14
U14
U14
U14
U12
U12
U12
U12
U12
2001
U14
U14
U14
U14
U14
U14
U14
U14
U14
U14
U14
U14
2000
U14
U14
U14
U14
U14
Mail completed forms to:
Baltimore International Soccer Academy
4313 Kolb Avenue
Baltimore, Maryland 21206
Baltimore International Soccer Academy
4v4 BISA Cup Tournament Entry Form
Payment and completed roster form must be sent together.
Soccer Club Name _________________________________________ Team Name _________________________
Address _________________________________________ City _____________ State ________ Zip __________
Team Manager __________________________________________ Cell # _______________________________
Email Address __________________________________________
Age Bracket
[ ] U6
[ ] U8
[ ] U10
[ ] U12
[ ] U14
Please Print Clearly
Player 1 (Captain)
Player 2
Name _________________________________________
Name _________________________________________
__Male __Female
__Male __Female
Age _____
DOB ___/___/___
Age _____
DOB ___/___/___
Signature _____________________________________
Signature _____________________________________
Signature of Parent/Guardian
Signature of Parent/Guardian
By signing, you have read and agreed to the Waiver of
Liability & Rules, as well as the Medical Release.
Player 3
By signing, you have read and agreed to the Waiver of
Liability & Rules, as well as the Medical Release.
Player 4
Name _________________________________________
Name _________________________________________
__Male __Female
__Male __Female
Age _____
DOB ___/___/___
Age _____
DOB ___/___/___
Signature _____________________________________
Signature _____________________________________
Signature of Parent/Guardian
Signature of Parent/Guardian
By signing, you have read and agreed to the Waiver of
Liability & Rules, as well as the Medical Release.
Player 5
By signing, you have read and agreed to the Waiver of
Liability & Rules, as well as the Medical Release.
Player 6
Name _________________________________________
Name _________________________________________
__Male __Female
__Male __Female
Age _____
DOB ___/___/___
Age _____
DOB ___/___/___
Signature _____________________________________
Signature _____________________________________
Signature of Parent/Guardian
Signature of Parent/Guardian
By signing, you have read and agreed to the Waiver of
Liability & Rules, as well as the Medical Release.
By signing, you have read and agreed to the Waiver of
Liability & Rules, as well as the Medical Release.
Signature of Coach/Manager: __________________________________________________________________
By signing, you have read & agreed to the “Waiver of Liability & Rules