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Application for 2012 US Youth Soccer NM Open State Cup presented by the New Mexico Sports Authority

May 5-20, 2012
Application Deadline February 1, 2012

NOTE: Your application is not completed until your payment has been received by the NMYSA office.  The deadline for receipt of payment ($650.00) is February 1, 2012.  If we choose to accept a late application, a late fee of $100.00 per day will be assessed.  If payment is received after February 8, 2012, the team will not be accepted and your check will be returned.  When your web form is successfully submitted, you will see a confirmation page.  For any questions about State Cup, please contact the State Office.  For any questions about this page, please contact our webmaster.

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Division: Boys Girls Age group: U-13 U-14 U-15 U-16 U-17 U-18 U-19 Team information: Team name: League: Club (if applicable): Place (if 1-4) in State Cup 2011: Prior team name, if changed (IF NO CHANGE, SO STATE): Team head coach information: Head coach name: Head coach e-mail:  Enter a valid email address. Example: name@company.com Head coach phone (evening):  Enter a valid phone number. Example: 123-456-7890 Head coach phone (day):  Enter a valid phone number. Example: 123-456-7890 Are you head coach of another team in State Cup? If so, give team name & age/gender of others (IF NONE, SO STATE): Team contact person information: Contact name: Contact e-mail:  Enter a valid email address. Example: name@company.com Contact street address: Contact city: Contact state: Contact ZIPCode: Contact phone (evening):  Enter a valid phone number. Example: 123-456-7890 Contact phone (day):  Enter a valid phone number. Example: 123-456-7890 Team volunteer (NOTE: each team is requested to identify a team volunteer who will be available to work during the tournament): Volunteer name: Volunteer e-mail:  Enter a valid email address. Example: name@company.com Volunteer phone (evening):  Enter a valid phone number. Example: 123-456-7890 Volunteer phone (day):  Enter a valid phone number. Example: 123-456-7890 AGREEMENT: It is understood that the US Youth Soccer New Mexico Open State Cup is a part of the US Youth Soccer National Championship Series. By submitting this application and participating in the Tournament, this team agrees to participate in, if qualified, and pay all fees associated with participating in, the US Youth Soccer Region IV Championships (June 18-24, 2012, Phoenix, AZ). Minimum number of games not guaranteed. 2012 US Youth Soccer New Mexico Open State Cup play precludes participation in the 2012 Kohl's American Cup. Checking the "agreement" box below binds this team to this agreement. Box must be checked for application to be accepted: Check if you agree to the above conditions Head coach name for acknowledgement: Date of acknowledgement: PAYMENT: Non-refundable application fee of $650 (by 1 Feb) [plus $100/day late fee until 8 Feb] [Note: a credit card processing fee will be added to all credit card transactions] Payment method: I am calling the state office with my credit card information (505-830-2245) [processing fee applies] I have mailed my check to NMYSA, 2825 Broadbent Pkwy NE, Suite D, ABQ 87107 (enter check # in comments below) I am delivering my check to the state office (enter check # in comments below) Notes and comments: APPLICATION IS NOT COMPLETE AND ACCEPTED UNTIL PAYMENT IS RECEIVED.

 

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