Jarosi-Willis Memorial

THE 2004 JAROSI-WILLIS MEMORIAL CUP APPLICATION DEADLINE IS APRIL 12, 2004.
View the 2004 Jarosi-Willis Memorial Hosting Agreement (PDF File)
Note: The Jarosi-Willis Memorial Cup Does NOT Accept Credit Card Payments.

When completing the Jarosi-Willis Memorial application, please use proper type and capitalization
(Upper and lower case. Example: "Red Tigers SC" instead of "red tigers sc" or "RED TIGERS SC").
Applications submitted in ALL CAPS/all lower case will not be accepted. Also, do not use punctuation (',.&;:() etc).
Thanks for your cooperation and we appreciate your interest in the Jarosi-Willis Memorial in Columbus, Ohio.
To Register for the 2004 Jarosi-Willis Memorial Cup, please complete the form below.

TEAM INFORMATION

Team Name:

Gender:
Boys Girls

Age Group: verify division by age

Club Name:

Birthdate of Oldest Player:
/ /

Team Affiliation: (choose one)
US Youth Soccer US Club Soccer N/A

If checked US Youth Soccer, your State Association:

Coach's Name:

Coach's Phone #s (with area code):

PRIMARY CONTACT PERSON

This person will serve as the primary contact for all Jarosi-Willis Memorial Cup communications.
Please be sure to enter a valid working email address, as confirmation of your
registration will be be delivered to the Primary Contact's Email address indicated below.

Team Contact:

Role with Team:

Team Contact Email Address:

Confirm Email Address:

Team Contact Street Address:

Team Contact City, State, Zip:

City	State	Zip

Team Contact Home Phone # (with area code):

Team Contact Work Phone # (with area code):

TEAM PERFORMANCE HISTORY

Although not required, the information requested below helps the committee in the team selection process.

# of years team has played in the Jarosi-Willis Cup:

2003 Record at the Jarosi-Willis Memorial:

Won:

Lost:

Tied:

Fall 2003 League Name:

Division:

Record:

Place:

Most Recent State Cup
or State Championships:

Division:
N/A

Record:

Place:

Spring 2004 League Name:

Division:

Record:

Place:

Tournament Name

Year

Div.

Record

Place

Additional Comments: List any information which will assist the selection committee in a proper evaluation.

SUBMISSION & PAYMENT INFORMATION

STEP 1: Once you hit Submit below, your application will be sent to the Jarosi-Willis Memorial Cup. Your form will not process if you do not enter a valid email address or fail to check the verification boxes.
STEP 2: When you submit your application, you will be given a web page that contains your "Tournament ID #.". You should make two copies, one to keep on file and one to mail with your fees.
STEP 3: A check or money order (US Currency) must be mailed to the Jarosi-Willis Memorial Cup, 18 Huber Village Blvd, Westerville, OH 43081 and made payable to the Jarosi-Willis Memorial Cup in the amount of $425.00 for U11 thru U17 divisions ($200 bond for U16-19 teams) and $375.00 for U9 and U10 divisions.
Note: Registrations are not complete until payment has been received. A complete list of accepted teams will be posted on our web site at www.jarosi.com

TERMS & AGREEMENTS

	I understand that inclement weather, acts of God or other uncontrollable circumstances are always a possibility and such occurrences may result in the abbreviation or cancellation of tournament games and that in the event this occurs, no refunds (partial or full) will be given.
	I CERTIFY THIS APPLICATION IS ACCURATE AND COMPLETE.

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