This Torneo Internacional Intibucana Team and Visa Application is designed from teams who want to assure they are able to attend the Torneo Internacional Intibucana in July 2005. The Torneo Internacional Intibucana "Soccer Against Global Warming", (Want to Know More About Global Warming?) an International Youth Soccer Tournament will take place from the 21st to the 31st of July 2005 in La Esperanza, Intibuca, Honduras. La Esperanza is the high mountain center of Lenca Indian people in Central America. The first game will be played on Friday, July 22, 2005. We have devised this new short application for teams who want to ensure they are able to play in this historic tournament.
This short application process is necessary due to the number of visas that may need to be processed for the tournament. To use this short form - complete it, send in the team application fee and $175 per visa application for each player. *Teams or players who are US citizens require no visas to enter Honduras. As soon as we receive these fees, we send them an official invitation from FENAFUTH, the Federation Nacional de Futbol Hondureño, the Honduran Soccer Federation.
The rest of the fees and forms required can then be submitted upon your acceptance. You must complete all the following:
Dr. Carol Cross
CODET, S de R L
Barrio El Morera, Farmacia Galencia, Frente Bazar Reyna
La Esperanza, Intibuca, Honduras
| TEAM ID #: | (Number on Coach's Pass) |
| AGE GROUP: | U- _______ |
| SEX: | [ ]
BOYS [ ] GIRLS |
| CLUB NAME: __________________ |
TEAM NAME: _______________ |
(Team name you want to appear on the schedule, as short as possible please)
CONTACT PERSON'S NAME (person who will get all mail a communications):
| Contact/Manager
Name: _____________________ |
Address: |
| City: __________________, | Zip: ___________ |
| Home Phone: ____ _____________ | Work Phone: ___ - ___________________________ |
| Cell Phone: ___ __________________________ | Fax: ____ __________________________ |
| email: ______________________ | |
(required information)
| COACH'S NAME: | Address: |
| City: , | Zip: ___________ |
| Home Phone: ____ _______ | Work Phone: ____ _____ |
| Cell Phone: ( ) ________ | Fax: ( ) ______________ |
| email: ___________________ | |
(required information)
The Tournament Committee will post a list, on the website, each week of teams entered into each tournament. If you do not see your team name on the list within two weeks of sending in your application, you should contact the State Office to verify.
According to the ISAI Risk Management Policy, Disclosure Forms must be on file for all persons working with the team to include coach, assistant coach, trainer and team manager and these individuals must have and display the blue Risk Management Badge to be on the sideline during the competition.
TEAM INFORMATION FORM
(Required for recreational and Open cup teams)
| CLUB:_____________________ | TEAM NAME:________________ |
| COACHES NAME: ____________________ | COACHING LICENSE LEVEL:__________ |
| ASSISTANT COACH NAME:____________ | COACHING LICENSE LEVEL:__________ |
| TRAINER NAME: ____________ | COACHING LICENSE LEVEL:__________ |
| HOW WERE THE PLAYERS SELECTED TO THE ROSTER? |
| ROSTER GIVEN
TO COACH 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. |
| ROSTER GIVEN
TO COACH AND COACH MADE SELECTION FROM NAMES 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. |
| CLUB TRAINING AND/OR AUDITIONS | CLUB/TEAM TRYOUTS AND SELECTION |
| NUMBER OF PLAYERS RETURNING FROM PREVIOUS YEARS TEAM: ________ of _________ |
| PLAYERS LEAGUE INFORMATION: |
| WHAT IS YOUR LEAGUE NAME:_____________________________________ |
| LEAGUE RECORD |
| WHICH FLIGHT DID THE TEAM PLAY IN: _______ OF _______ FLIGHTS |
| TOTAL NUMBER OF LEAGUE GAMES PLAYED: _____________ |
| WINS___________ LOSSES___________ TIED _____________ |
| TOURNAMENT RECORD: |
| NAME OF
TOURNAMENTS THE TEAM PLAYED IN AND RECORD: FLT; ______ PLACED ____ OF ____ TEAMS WON:____ LOST:____ TIED:___ FLT; ______ PLACED ____ OF ____ TEAMS WON:____ LOST:____ TIED:___ FLT; ______ PLACED ____ OF ____ TEAMS WON:____ LOST:____ TIED:___ FLT; ______ PLACED ____ OF ____ TEAMS WON:____ LOST:____ TIED:___ FLT; ______ PLACED ____ OF ____ TEAMS WON:____ LOST:____ TIED:___ FLT; ______ PLACED ____ OF ____ TEAMS WON:____ LOST:____ TIED:___ FLT; ______ PLACED ____ OF ____ TEAMS WON:____ LOST:____ TIED:___ FLT; ______ PLACED ____ OF ___ TEAMS WON:___ LOST:____ TIED:___ |
ADDITIONAL INFORMATION: (Please give the Tournament Committee a complete and accurate picture of the quality of the team. This information may be used in the final placement of teams in brackets. Use reverse side of this sheet if additional space is required).
To the best of my knowledge, all of the required Risk Management Disclosure Forms are on file. This information is a complete and accurate description of my team.
| Signed: _______________________________ |
| Print Name: _________________________________ |
| Position: ____________________________________ |
| Phone Number: _________________________________ |
| Email address: __________________________________ |
Application Form
| RAHF Region Name: ___________ | Team Number: 2005 - _____________ |
| Region Name: __________ | RAHF Region Number: ___________ |
| Age Division: U-________________ | Region Number: __________ |
| Boys Team_______ | Girls Team_______ |
| Uniform Color (Jerseys Only): _________________________________ | |
| Team Leader/Contact Person: ________________________________ | |
| Team Name: ______________________________________________ | ||
| Address: ______________________________ City:_________________ State:_____ Zip___________ | ||
| Phone | (Home) | (_______)______________ (Bus.) (________)_____________ |
| (Fax) | (_______)__________________ | |
| (E-Mail) | ____________________________@____________________ |
|
| (Coach information below, may be provided later.) | ||
| Coach: ___________________________________________________________ | ||
| Address:
_________________________________________________________
City:____________________________
State:_______ Zip:____________ |
||
| Phone | (Home) | (_______)______________ (Bus) (_____)____________ |
| (Cell) | (_______)______________ (Fax) (_____)____________ | |
| (E-Mail) | ____________________________@________________ |
|
| Team
Referees YES, we
will provide _______ referees. Referee Deposit will be
refunded. |
| TEAM HISTORY How long has team been organized: |
| Other
major tournaments played in the last 3 years:
_____________________________________________________ __________________________________________ |
| Honors
or awards won in the last 3 years: ____________________________________________________ ________________________________________ |
| PRIMARY
reason for attending the tournament (competition; fun;
seeing Honduras, etc.): ______________________________________________________________ ________________________________________________________________ |
| TRAVEL
INFORMATION: Arrival Date in Honduras: ___________ Departure date: _______ |