Registration Form

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The Fairfax Sportsplex
Youth Recreation Soccer 2015/2016
League Registration Form
Session 1
November 14 – December 20, 2015
Deadline Nov 5th
6 games
6V6
$695
Session 2
January 2 – February 7, 2016
Deadline Nov 23rd 6 games
*may have games 12/27, 1/1 or 1/18
Session 3
February 13 – March 20, 2016
Deadline Jan 22nd
6 games
*may have games MONDAY 2/15
5V5
Individual
AGE GROUPS
$640
$100
6 on 6 leagues:
U6 COED, U7-U19 Girls, and U7U19 Boys
6V6
5V5
Individual
$760
$715
$110
6v6
5v5
Individual
$760
$715
$110
5 on 5 leagues:
U9-U12 Girls, U8-U12 Boys
To Register
Fill out the form below for either
team or individual registration
and mail with payment to:
The Fairfax Sportsplex
6800 Commercial Drive
Springfield, VA 22151
Games are played Friday 7pm to 10pm, Saturday, 7am to 11pm and Sunday, 7am to 8 pm. Please contact the League
Director for specific age group time brackets. We accept individual registrations for age groups U6-U13. Children will be
grouped together by age to form team. We rely on parents to coach teams made up of individuals.
Teams in Session 1 are guaranteed a spot in Session 2 and Teams in Session 2 are guaranteed a spot in Session 3 only if
full payment is received by the registrations deadlines. EARLY REGISTRATION IS HIGHLY RECOMMENDED!
This league is intended for RECREATION (house) level players only. Each team may only carry 2 Travel (carded) players.
Exceptions may only be made by the League Director.
For more information please contact: Nicole Brower, League Director
nicolebrower@verizon.net 703-723-3490
YOUTH RECREATION SOCCER 2014/2015 – TEAM REGISTRATION
Session 1
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Session?
Session 2
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Session 3
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Returning Team from Previous
Y/N
Team Name
Team Color
Coach’s Name
Age Group
Boys
5v5
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Street Address
City
State
Zip
Phone (home)
Phone (alt)
Email
INDIVIDUAL REGISTRATION (not necessary for team registration)
Child’s Name
Parent’s Name
U6 – U13 ages only
Date of Birth
Boy
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Girl
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Street Address
City
State
Zip
Phone (home)
Phone (alt)
Email
WWW.FAIRFAXSPORTSPLEX.COM The ORIGINAL Sportsplex est. 1992
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6v6 ☐
Girls
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