NOTE: Please complete the application and provide all information requested. Incomplete applications will be returned. Note that the club President and League Registrar will get a copy of this application. 1) USSF Organization Membership Club Name USSF Organization Membership (select all that apply) US Club USYSA SAY AYSO None Other 2) Basic Club Information Year of Establishment Club Website 3) Clubs may be required to submit and maintain a Performance Bond based upon the number of teams 3 Teams - $250 4 or more teams - $500 4) Board of Directors Role Name EMail Address Contact Number President Field Coordinator League Registrar Director of Coaching Treasurer 5) Active Teams New Clubs must have at least three active* teams in order to be considered for CCSL Club Membership * An active team is defined as possessing a roster of at least 8 players for 2011:U7-2010:U8, at least 11 players for 2009:U9-2006:U12, and at least 13 players for 2005:U13 and above. Each player may only be rostered on one team. # Gender Age Group Team Name 1 [--] Boys Girls [---] 2011:U7 2010:U8 2009:U9 2008:U10 2007:U11 2006:U12 2005:U13 2004:U14 2003:U15 2002:U16 2001:U17 2001-1999:U17-19 2000-1999:U18-19 2 [--] Boys Girls [---] 2011:U7 2010:U8 2009:U9 2008:U10 2007:U11 2006:U12 2005:U13 2004:U14 2003:U15 2002:U16 2001:U17 2001-1999:U17-19 2000-1999:U18-19 3 [--] Boys Girls [---] 2011:U7 2010:U8 2009:U9 2008:U10 2007:U11 2006:U12 2005:U13 2004:U14 2003:U15 2002:U16 2001:U17 2001-1999:U17-19 2000-1999:U18-19 4 [--] Boys Girls [---] 2011:U7 2010:U8 2009:U9 2008:U10 2007:U11 2006:U12 2005:U13 2004:U14 2003:U15 2002:U16 2001:U17 2001-1999:U17-19 2000-1999:U18-19 5 [--] Boys Girls [---] 2011:U7 2010:U8 2009:U9 2008:U10 2007:U11 2006:U12 2005:U13 2004:U14 2003:U15 2002:U16 2001:U17 2001-1999:U17-19 2000-1999:U18-19 6 [--] Boys Girls [---] 2011:U7 2010:U8 2009:U9 2008:U10 2007:U11 2006:U12 2005:U13 2004:U14 2003:U15 2002:U16 2001:U17 2001-1999:U17-19 2000-1999:U18-19 7 [--] Boys Girls [---] 2011:U7 2010:U8 2009:U9 2008:U10 2007:U11 2006:U12 2005:U13 2004:U14 2003:U15 2002:U16 2001:U17 2001-1999:U17-19 2000-1999:U18-19 8 [--] Boys Girls [---] 2011:U7 2010:U8 2009:U9 2008:U10 2007:U11 2006:U12 2005:U13 2004:U14 2003:U15 2002:U16 2001:U17 2001-1999:U17-19 2000-1999:U18-19 9 [--] Boys Girls [---] 2011:U7 2010:U8 2009:U9 2008:U10 2007:U11 2006:U12 2005:U13 2004:U14 2003:U15 2002:U16 2001:U17 2001-1999:U17-19 2000-1999:U18-19 10 [--] Boys Girls [---] 2011:U7 2010:U8 2009:U9 2008:U10 2007:U11 2006:U12 2005:U13 2004:U14 2003:U15 2002:U16 2001:U17 2001-1999:U17-19 2000-1999:U18-19 6) Competitive Teams How many competitive teams does your Club have? How many teams will be enrolled in to CCSL Competitions? 7) Home Fields Clubs must provide CCSL with proper permits for a facility or facilities at which your home games will be played. Home Game Fields: Please list all fields (name, address, and the agegroup that the field is valid for) your club plans on using for games: # Field Name Field Address (Street,City,State,Zip) 1 2 3 4 5