Where: Westgate Soccer Complex

When: From 2 - 4PM on Sunday afternoons for 7 weeks beginning:

 15 Aug- (Sep 5-26 off)-Oct 10.

Cost: $40.00

FIRST NAME _____________ LAST NAME ______________________

AGE ______ Boy____Girl_____

DATE OF BIRTH _________________________________

Address__________________ City _________________State/Zip ________

Telephone Number __________________Email _______________________

Parent/Legal Guardian Name:___________________________ (Please Print)

Signature:______________________________________________________

Check #___________________

I am interested in being a manager or coach _________

2. Registration FEE: $40.00 Check Made Payable to : DYSA

    Sibling Discount - $10 (minus ten dollars)

3. MAIL FORM AND FEE TO: DYSA, PO Box 6234 Dothan, AL 36302

For more information:

    Email: dysa@snowhill.com Web Site: www.dysa.net