receipt.pdf - Thank you for registering(Your Copy If you...

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Thank you for registering. (Your Copy) If you select a payment plan and are paying by check. YOU MUST BRING POSTDATED CHECKS WITH YOU TO REGISTRATION. THIS WILL AUTOMATICALLY CALCULATED FOR YOU AND WILL BE DEPOSITED ON SPECIFY DATE ON THE CHECK. Application Date: Application Date: Application Date: 5/16/2017 5:22:54 PM Registration Fees Registration Fees Order# Applicant Club Applied To Season Registration Fee 2- 3399934 Wesley Kinney Poway Vaqueros Academy - Registration Fee, 2002 ,Competitive 17 Fall 2017-2018 $1,425.00 Total Registration Fees: $1,425.00 Payments / Credit Authorizations Received Payments / Credit Authorizations Received Order# Paid By Type Payment Info Status Amount to be Charged Amount Applied 2-3399934 James Kinney Visa 6001 Open 1,425.00 $0.00
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Thank you for registering. (Club Copy) If you select a payment plan and are paying by check. YOU MUST BRING POSTDATED CHECKS WITH YOU TO REGISTRATION. THIS WILL AUTOMATICALLY CALCULATED FOR YOU AND WILL BE DEPOSITED ON SPECIFY DATE ON THE CHECK. Application Date: Application Date: Application Date: 5/16/2017 5:22:54 PM Registration Fees Registration Fees Order# Applicant Club Applied To Season Registration Fee 2- 3399934 Wesley Kinney Poway Vaqueros Academy - Registration Fee, 2002 ,Competitive 17 Fall 2017-2018 $1,425.00 Total Registration Fees: $1,425.00 Payments / Credit Authorizations Received Payments / Credit Authorizations Received Order# Paid By Type Payment Info Status Amount to be Charged Amount Applied 2-3399934 James Kinney Visa 6001 Open 1,425.00 $0.00
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California State Soccer Association - South 20 SEASONAL YEAR - FALL SUMMER SPRING First Name* MI Last Name* YOUTH PLAYER REGISTRATION APPLICATION Relation* Street Address* City* State ZIP* Home Phone** Work Phone** Mobile Phone** Email* Gender* M - Male F - Female New Player Returning Player If returning, Cal South Player ID Number: 20 First Name* MI Last Name* Gender* DOB (MM/DD/YYYY)* Rank Seasons Played Height ft. in. Weight lbs. School Name* League* Grade Club* Team ID Number Shirt Size Short Size Sock Size Age Group Division Emergency Contact #1* Emergency Contact #2 Phone* Phone If applicable, list any medical problems(s)/physical limitation(s) the player has: Coach Manager Parental/Volunteer Support: Referee Board Position Fields Publicity Concession Fundraising We, the registrant and the registrant's legal parent or guardian, hereby agree and acknowledge the following: (1) We agree to abide by the rules of Cal South and its affiliated organizations and sponsors. (2) We recognize the inherent risk of serious or permanent physical injury and possible death associated with youth soccer activities and games. In consideration for Cal South accepting the youth player's registration and participation in its sanctioned youth soccer leagues, tournaments and team travel activities (“Youth Programs”), we hereby release, discharge and/or otherwise indemnify and hold harmless Cal South, its affiliated
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  • Fall '17
  • Joe Holiday

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