Max number of players allowed to be registered for a team

Check YES if you want the whole League to be covered to 25K Medical. There is an additional charge of $5 per player if you select YES.

Check YES if your league wants Officers and Directors Insurance coverage. An additional service fee of $25 will be charged to the League's Affiliation fee. All the Officers they you have given information for will be listed on the insurance policy.

Check YES if you want the NJSA to charge an extra $ Amount for every player registered with your League. You will be prompted as to the amount that you want to charge. This amount will be refunded to your League upon monthly reconciliantion.

Click YES if you want all the players in your league to be covered by medical insurance limiter higher than normal. You will have the choice between 10k or 25k medical coverage.

League Registration
NEW JERSEY SOCCER ASSOCIATION P.O. BOX 9765 TRENTON, NJ 08650 www.soccernjsa.com
LEAGUE AFFILIATION
OFFICIAL INFO
*LEAGUE NAME:
WEBSITE:
*MEMBERSHIP TYPE:	Select Membership Premier Recreation Regional Professional Indoor Tournament Outdoor Tournament U20/U23 Development Other Soccer Organizations Indoor Facility 7 v 7 Tournament Out of State Type 1 Out of State Type 9 Associate League USASA League NJ Cups Guests NJ State Futsal
*START DATE:
*END DATE:
*GAME LENGTH:	Min.
*MAILING ADDR:
*CITY:
*STATE:
*ZIP:
*OFFICIAL LEAGUE E-MAIL ADDR:
ADDITIONAL LEAGUE E-MAIL ADDR:
PERSONAL INFO
*PRIMARY CONTACT:
*CONTACT E-MAIL ADDR:
ADDITIONAL CONTACT E-MAIL ADDR:
*ADDRESS:
*CITY:
*STATE:
*ZIP:
HOME TEL:	()- -
*CELL:	()- -
FAX:	()- -
BOARD MEMBERS
President: Name Mailing Address City State Zip E-mail Telephone   Discipline Committee Rep.: Name Mailing Address City State Zip E-mail Telephone   CERTIFIED REF. ASSIGNOR: Name Mailing Address City State Zip E-mail Telephone Add Board Member
SPECIAL REQUESTS
*MAX. NO. OF PLAYERS:	(what is this?)
*LAST REGISTRATION DATE:
Additional Medical Insurance:	Yes No 10k 25k  (what is this?)
Officers Insurance Desired:	Yes No (what is this?)
Extra fee per player:	Yes No (what is this?)
By clicking on REGISTER THIS LEAGUE you agree to abide by all the Rules and Regulations of the New Jersey Soccer Association and that the league will be held responsible for any and all financial obligations incurred by the above named organization toward the NJSA or any other affiliated member of the NJSA.
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