Us Youth Soccer Application To Travel Form

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US Youth Soccer
A Proud Member of US Soccer
Affiliated with the Federation Internationale de Football Association
Please Type or Print Clearly - Do Not Staple
Please Type or Print Clearly - Do Not Staple
I. APPLICATION TO TRAVEL
Everyone requesting permission to travel must fill out this section.
Team Name
____________
Age Group U-
___
Type of Team (see reverse side)
____
B / G (check one)
League or Home Association
State Association or Affiliate
______ Team Departure Date _____________
Team Manager or Coach
Telephone (
)
______
W
Address
___________________
E-mail
__ _________
(
)
_______
H
City
____________
State
Zip
(
)
_________ _FAX
I state that during the dates below, the team has no conflicting playing commitments at home. All players are fully insured to cover them against injuries
sustained on the field and during transportation.
Signature of Team Manager or Coach
____________
Date __________________
II. TRAVEL TO A TOURNAMENT
If you are requesting permission to travel to a tournament, you must fill out this section.
A copy of the approved Hosting Agreement or official brochure for this tournament must be attached.
We request approval to play in the
_____________ Tournament, to be held in ________________
______________________________
__________, during the dates of _______________________________________________________
Tournament Director or Contact Person
_____________
Telephone (
)
______ W
Address
E-mail _______________________________
(
)
____
H
City
State
Zip
Country
________________
(____ )
_____
FAX
III. TRAVEL TO PARTICIPATE IN GAMES
If you are requesting permission to travel to participate in games, you must complete this section.
A copy of the approved hosting form or, if outside the US, a copy of the official brochure, pamphlet, invitation, or other applicable material
about the tournament or games must be attached.
We request permission to play games between the dates from
_________ to ________________in the following locations
(and attach a separate sheet, if necessary):
OPPONENT
CITY
STATE OR COUNTRY
1.
______________
2.
______________
3.
______________
Hosting Organization
______________
Contact Person
____________________
Telephone (
)
__
W
Address
E-mail______________________________
(_____)_________________ H
City
State
Zip
Country
___________________
(
)
______ FAX
APPROVAL
(For Official Use Only)
STATE ASSOCIATION OR AFFILIATE__________________________________________
Date __________________________________
By
_____________
Title __________________________________
In granting this permission to travel, neither US Youth Soccer nor its State Associations or Affiliates shall be liable for transportation, lodging, or injury to persons or
property sustained in the course of the approved event.
DISTRIBUTION: χTeam (White) / χ State Association/Affiliate (Canary)
3/1/01

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