Permission to Travel to a US Youth Soccer or USASA Sanctioned Event
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Person Completing Form:
Coach
Team Manager
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First Name:
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Last Name:
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E-mail Address:
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Street Address:
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City:
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State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
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Zip:
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Home Phone (w/area code):
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Work Phone (w/area code):
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Team Name:
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Club Name:
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Team Number:
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Age Group:
Under 7
Under 8
Under 9
Under 10
Under 11
Under 12
Under 13
Under 14
Under 15
Under 16
Under 17
Under 18
Under 19
Adult
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Team Gender:
Male
Female
Coed
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Team Type:
Youth Academy Team
Youth Competitive Team
Youth Recreational Team
Adult Division 1
Adult Division 2
Adult Division 3
Adult Over 30
Adult Masters
Adult Coed
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Tournament Attending:
Tournament or Event Website:
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City of Tournament:
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State of Tournament:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
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Tournament Affiliation:
United States Adult Soccer Association (USASA)
United States Youth Soccer (USYS)
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Dates of Tournament:
(e.g., September 4-5, 2010 )
*Please note that every team must have an OSA approved roster before traveling.
*
Indicates Response Required