ࡱ> ikh#` bjbjmm : %2222ttt8, 8^^^^^^-A MAY0";0"]$$_ha] "-]22^^]44428^^444rTj^ X\_tF*^08^ b( b b(UvT4Dc7UUU]]UUU8^ t t222222 UNITED STATES ADULT SOCCER ASSOCIATION. INC. National Cups Entry Form 2008 - 2009 THIS FORM MUST BE TYPED AND ALL SPACES COMPLETED. Check One ENTRY FEE  FORMCHECKBOX  US National Mens Amateur Cup $ 225 Men Amateur Status players only  FORMCHECKBOX  US National Womens Cup $ 225 Open to Women Pro & Amateur status players  FORMCHECKBOX  US National Mens Over 30 Cup $ 225  FORMCHECKBOX  US National Mens Under 23 Cup $ 225  FORMCHECKBOX  US National Womens Under 23 Cup $ 225  FORMCHECKBOX  US National Mens Open Cup $ 275 Qualifies Teams for the US Open Cup Full Name of Team Entering: ________________________________________________________________ State, Regional or National League Affiliation: _________________________________________________ Primary Uniform: Shirts Shorts Socks Alternate Uniform: Shirts Shorts Socks Team Manager: _____________________________________ Home Phone: ( ) Address: Cell Phone: ( ) _________________ City: Work Phone: ( ) State/Zip: ______________________________E-Mail: ____________________________________________ Team Coach: Home Phone: ( ) Address: Cell Phone: ( ) City: Work Phone: ( ) State/Zip_______________________________E-Mail: ____________________________________________ NOTE: Check with your State Association and Region for additional fees. All additional state association fees must be approved by the regional commissioner. NO TEAM will be allowed to compete at ANY LEVEL until this form (and the fee) has been received by the National State Association Cup Commissioner and the Regional Cup Commissioner. Only State Association, National League or Regional League checks will be accepted for cup entries, payable to USASA. Club and team checks will NOT be accepted. A team may enter more than one competition if it meets the criteria. One form required for each entry. A $500 bond is required from all state winners within one week of being declared the State Champion. Only State Association checks, Money Order, or Cashiers Checks will be accepted, made payable to the USASA. A return address must accompany that check. All decisions of the National Cup Committee are final and binding. I have read and understand the USASA National Cups Policies. I am entering the team named on this entry form with the full understanding that all games in these competitions will be governed by the USASA National Cup Policies, the Constitution and Rules of the USASA, the USSF, and The Laws of the Game as published by FIFA. ____________________________________________________________________________________________________________________ Printed Name of Applicant ____________________________________________________________________________________________________________________ Signature Date Return this Form and all fees to: Albert Espinoza, 1624 Poppy St. Long Beach, CA 90805, Phone (C) (562) 900-4389 e-mail  HYPERLINK "mailto:alespinoza@aol.com" alespinoza@aol.com Date Entry Form Received: ______________________________________ Time: _________________________________________________     8/25/08 NC ENTRY FORM .TU   : E F T U V f örfWDfW%jth.h>*B* CJUphh.h6>*B* CJ]phhG>*B* CJph%jh.h>*B* CJUphh.h>*B* CJphjh.h>*B* CJUphh.h5B* phh.h56B* phh.h56B* CJphh.h56>*B* CJphh.hB*CJphh.hB* CJ(phh.h5B* CJphjh.hUmHnHu.TUE .  ~  d0*x R&0*dh(( R&0*(( R&0*((  z( $ 0*e (a$ 0*$d N  ^  (^   . / = > ? 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