Iowa City Alliance

Alliance Fun Fours Registration Form

Sixth Annual Fun Fours 4v4 pick-up soccer in July

When- Monday and Wednesdays from 6:00pm-7:15pm, July 9th - August 1st.

Where- U of Iowa Recreational Soccer Fields Cost - $10 for Monday OR Wednesday or $15 for both.

Paper Registration Form and Program Information

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Player First Name
Player Last Name
Date of Birth
Sex	Male Female
Day	Choose Day Mondays Wednesdays Both Mondays and Wednesdays
Team	Choose Team Kixx Matrix Adrenaline Shockwave Tsunami Heatwave Flash Earthquakes Starz Diamonds Panthers Lasers Predators Attack Lightning Xplosion Illusion Other

Parent Name
Street Address
Address (cont.)
City
State
Zip Code
Home Phone
Work Phone
E-mail

Special Requests:

In consideration of participation in the 2007 Iowa City Alliance Fun Fours.
I, Parent or Legal Guardian Name  
(parent or legal guardian) do hereby release the Iowa City Alliance Soccer Club, the University of Iowa, all associates, employees, volunteers, officials and agents from any and all claims, liabilities, loss of service and cause of action of any kind for personal injury and property damage arising in any way out of participation.  Further, I agree to abide by all competition rules and regulation. By signing my name below, I hereby acknowledge that I have read the above; I understand it and agree to all the terms.

Do you agree to the above?                                                    No Yes

The cost is $10 for Mondays or Wednesdays and $15 for Mondays and Wednesdays.

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