As previously reported, our website database was corrupted. It has been restored from a backup made on Wed. 10/22/2014 at 10PM.

Unfortunately some information entered on the website between that time and about noon on Mon. 10/27/2014 may have been lost, and may have to be reentered.                 ... Webmaster

Winter/Spring Interest Form

American Youth Soccer Organization 
Winter/Spring Interest Form  

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Notes: (Do not re-submit this form to make changes)
  1. If this form does not work properly email the below information to the  Director of Secondary Programs .
  2. To change your registration or ask questions, contact us here .

Please add me to your list of players interested in participating in the Region 85 Spring Select programs.   I understand that I must have participated in the most recent Region 85 fall program to be eligible, and that submitting this form does not guarantee me a place in the program.

Program   Spring
Division The division you played in this fall.
Your Region  Region where you participated in the most recent fall season.
First Name

Date of Birth mm/dd/yyyy

Last Name Gender  (you are)     Male   Female  
Phone
Email

My parent or other relative will referee   Yes   No  
If a relative volunteers to referee you will be guaranteed a spot on a team.

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