Fusion Fall Kickoff

Online Tournament Application

Clarksville Shootout

* INDICATES A REQUIRED FIELD

Team Information
Team Name *				Coach's Name *
Club Name	Gender/Age *			U8 Players May Not Participate
Teams City	State Association			Registered Division

Primary Contact Information
First Name			Last Name *
Primary Email address: *
Contact is
At Least One Phone Number Must Be Entered
Home Phone	Work Phone	Cell Phone
Address
City		State	Zip
Alternate Contact Information
Alternate Contacts Name
Alternate Email address:
Alternate Contact is
Home Phone	Work Phone	Cell Phone

Team Performance History

Please include as much information as you can.
The more we know, the better we can assess your level of play.

If this selection is not filled out we will place you in the most competitive bracket when available.

	Total Played	Won	Lost	Tie	Played Up an Age Bracket
Record Last 12 Months (Exclude Tournament Play)
Tournaments Last 12 Months
Number of Tournaments Entered	Total Matches Played	Total Matches Won	Total Matches Lost	Total Matches Tied	Played Up an Age Bracket	Best Tournament Finish

						Division Requested
If more than one Division exist in any age bracket My Team request the following bracket placement (Select Competition Level Here)

Comments


Verification, Submission and Payment Please take this opportunity to check over your application to ensure that all the Required Fields have been completed. You MUST submit the application by clicking on the "Submit Application" button below for it to be received by the tournament. IF YOU NEED A COPY OF THIS FORM PLEASE PRINT BEFORE YOU HIT SUBMIT.
X	Please check to indicate your acceptance of the terms below.
	I understand that: The tournament reserves the right to accept or reject any team at its discretion. If my team is not accepted into the tournament I will receive a refund in full. Cashing of the check by the tournament submitted with application DOES NOT indicate acceptance.
	The application above is a COMPLETE and ACCURATE representation of my team's accomplishments and abilities.
	I understand that once a team is accepted and later withdraws, the entry fee is forfeited.
	I understand that action and champion photos of my team may be taken and that my team, the players or the parents/guardians of the players have no recourse to compensation or discretion regarding the use of the photos for purposes of promoting the tournament.
	I understand that inclement weather is a possibility and that such weather may result in the abbreviation or cancellation of tournament games. In the event this may occur, no refunds, full or partial, may be given.
	I understand that I will receive information regarding my team's participation in this tournament via email and that I am responsible for informing the tournament of changes to the account provided on this application.
	Please exclude my email in soccer tournament-related announcements.
	* INDICATES A REQUIRED FIELD Mail checks to: PUT TEAM NAME ON CHECK PLEASE Fusion FC % Lee Nadeau 852 Glendale Drive Clarksville, TN 37043 Phone (Cell) (931) 320-1499 email: nadeaut10@yahoo.com NOTE If you do not get our "Thank You" automatic response once selecting submit Application BUTTON your application was not sent - check all the required fields for an entry and then your "On Line" status. If you don't receive an email from the Tournament director stating receipt of your application within 48 hours check with the Tournament Director directly to ensure receipt. Please type the code from the image in here: