Golden Goal Tournament Registration

Team Name

Head Coach

Organization/Club

Address
Note: This address must match the billing address that is being used for a credit card payment.

City

State

Zip

Daytime Phone #

Nighttime Phone #

E-Mail

Select the box below for the Golden Goal Tournament you would like to attend:

Jun 26 - Jun 28 Girls JV & Varsity

Weeks subject to change

A $200 Deposit will reserve your teams spot

Check

Checks payable to "Golden Goal"
Must be in U.S. dollars
Mail checks to:
Golden Goal
191 King Street
Chappaqua, NY 10514

Credit Card

Card Number

Expiration Date

3 Digit Verification Code (found on back of card)

Name on Card

Credit card will be charged $200 - any further changes will require your authorization.

Golden Goal 191 King Street Chappaqua, NY 10514	For further assistance, please call 888.871.0777 Fax 215.504.7028