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846 Reading Road ● Mason, OH 45040  ●  [t] 513.573.9898  ●  [f] 513.573.9899
This application should be used for teams looking to play in one of our soccer leagues or tournaments.  All data posted from www.Wall2WallSoccer.com uses secure socket layer (SSL) technology.
 

Contact Information

Team Name:

 *

Has this team played at Wall2Wall Before?   *

If Yes and would like roster copied over, enter either previous team name or previous coaches name:  

Head Coach:

 *
Date of Birth: * [YYYY-MM-DD]
Address: *
City: *
State: *
Zip: *
Email: *
Day Phone: *
Evening Phone:
Mobile Phone:
   

League Information
Session: *
Age Group: *
Day: * click here for league days
Division: *
Level: *
League: *
   

Payment Information
Card Type: *
Card Holder: *
Card Number: *
Exp. Date: * [MM-YY]
Amount: * Teams are required to pay the full Special Price at the time of registration.  Participation in the Special guarantees a spot in both Winter 1 and Winter 2 sessions.  (Prices do not include referee fees)
Applications must be accompanied by a $100.00 deposit and a credit card number, which will be charged if the team has not paid in full by the 1st game.  Full payment is due before the 1st game. If the full payment is not made before the 1st game your team may not play that day and will be taken off the schedule.  Acting as the coach, I understand that I am personally responsible for any and all fees.
 
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Comments:
 

 

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- You must have Flash installed