Tournament Membership Form

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Tournament Membership Form

MEMBERSHIP FORM

[ ] African/Caribbean Youth Soccer Tournament (Afro-Carib Cup)

[ ] 2004 Torneo Internacional Intibucano in Honduras

Seasonal YR ___ to_____

League Name ____________________________________

Age Group U ________ Div ________

Club & Team _________[ ] District League

[ ] Club Team Player [ ] R Recreational [ ] Competitive = C

Last Name _________First Name ____________ Init.________

Address _______________________ Area __________

City ____________ State _______ Country _________

Mail Code ___________ Preference for RAHF Mailings

___________________________________________

Phone _________ Month _________Day Year _______

[ ] Male = M [ ] Female = F

Passport Country _______ Code ________Number __________

Birthdate ______________

Father's Name ____________________________

Occupation __________________________________

Bus. Phone _______Guardian ___________________

(Optional

_____________________________________________

Mother's Name ___________________________

Occupation __________________________________

Bus. Phone _______

(Optional

_____________________________________________

Guardian ___________________

Occupation __________________________________

Bus. Phone ________

(Optional

_____________________________________________

List any medical problems or prohibition of player ____________________________________________

Person to notify in emergency _____________________

Phone ________________

Doctor to notify in emergency ___________________

Phone ________________

IMPORTANT

I, the parent/guardian of the below-named player, a minor, agree that I and the player will abide by the rules and regulations of ISAI, Inc., the RAHF, its affiliated organizations and its sponsors ("RAHF articles"). In consideration of the player's participation in the soccer programs and activities of the RAHF Parties ("the Programs"), I, for myself and the player and our respective heirs, administrators and successors, intending to be legally bound, hereby release and indemnify the RAHF Parties, the owners and operators of the facilities used for the Programs, and their respective directors, officers, employees, agents and representatives from and against all claims, liabilities, damages or causes of action arising out of or in connection with the player's participation in the Programs including, without limitation, player's transportation to/from any Program, which transportation is hereby authorized. I further grant the RAHF Parties the right to use the player's name, picture and/or likeness in printed, broadcast and other material concerning the Programs provided such use is related to the player's status as a participant in the Programs.

Name: ________________________________________

Print Name of Parent/Guardian Player: ________________________________________

Signature ___________Date: ____________

Become a Friend of Atletico Lenca.

Want to see this forward looking team grow? We are seeking to build our own stadium where Member/Sponsors can enjoy themselves when they come to Honduras. Become a friend and get special treatment. Email Dr. Cross at exportfacs@aol.com for more information.

Want to know more? You can get all the fun of ownership and the benefits of belonging to this world Class team by becoming a sponsor. Want to be on the field with this team? Email us at exportfacs@aol.com or honducopa@yahoo.com

Dr. Carol Cross or Dr. Ramon Dario Argueta

CODET, S de R L

Barrio El Morera, Frente Bazar Reyna

La Esperanza, Intibuca, Honduras

Dr. Argueta: Telephone 504-783-0054 or 504-398-9554

Dr. Cross: 504-783-0421

2005-2006 Honduras Soccer Team Membership & Sponsorship Available For Enrollment June 1, 2005. Make Sure You Don't Lose Your Chance. Send In Your Deposit Now! Belong To The Team As A Member Or Sponsor The Team As A Marketing Partner. We Promise To Show You A Good Time!

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