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Fax:513-769-0500

District REPORT FORM - FINAL RECONCILIATION
SOCCER ASSOCIATION FOR YOUTH
One North Commerce Park Drive, Suite 306-320
Cincinnati, Ohio 45215

www.saysoccer.org
FIRST NAME
LAST NAME:
Title:
ADDRESS
CITY
STATE
 ZIP
HOME PHONE
WORK PHONE
E-MAIL
 
Season Year
BREAKDOWN BY AGE GROUPS
   
NUMBER OF TEAMS
    
PRE-PAID
PLAYERS
 
Short-Sided
(9 v 9 or less)
Full-Sided
(11 v 11)
  
FINAL NUMBER
OF PLAYERS
Pre-School (U-6)
 
Passers (U-8)
 
Wings (U-10)
 
Strikers (U-12)
 
Kickers (U-14)
 
Minors (U-16)
 
Seniors (U-19)
 
Total
     
Total

District INFORMATION
   
1. Total Final regular players for the current year (b) X $9.00 player fee =
$ (1)
2. Total Pre-Paid Players for the current year (a) X $9.00 player fee...... =
$ (2)
3. Subtract Line 2 From Line 1 ......................................................................................=
$ (3)
4. If Line 3 is negative, please select a reimbursement option:  
5. If Line 3 is positive, please select a payment option below.  
   
PAYMENT INFORMATION
If payment is due, please fill in all fields for only one payment method below.
   
Option 1: Credit Card Info
Visa
MasterCard
Full Name on Credit Card
Credit Card Number
Security Code (VCC)
Expiration Date MM/YYYY
     
Option 2: Check
Full Name on Account
Account Number
Routing Number
Check Number (optional)
     
Option 3: Send Check by Mail
(please send checks to address above and make payable to SAY Soccer)
Check Number
Amount Enclosed $
   

INSTRUCTIONS FOR District REPORT FORM / FINAL RECONCILIATION

Purpose: This form is turned into the National Office along with your player rosters no later than 30 days after your first game. It is a reconciliation form that is finalizing your season's player count and the final team count for your District.

To Complete this Form: First, list the number of players in the Pre-Paid Player column from the Team Packet. Then, list your total team count per age division, in either the Short-Sided column (if that's what they played) or in the Full-Sided column (if they played full-sided). Then, in the number of players column, list the total number of players in that age division. For example, if you have 9 Passer short-sided teams and each team has 10 players, then your total number of players for Passers would be 90. Continue listing all of your divisions.

For the District information at the bottom:

Line 1 list the actual final number of players, multiplied by the player fee and record.

Line 2 list the number of Pre-Paid Players, multiplied by the player fee.

Line 3 you subtract Line 2 from Line 1. If the amount is a positive number that number is the amount OWED to the National Office. If the amount is a negative number that is the amount of credit you have with the National Office. You can chose to have a check issued or keep that credit on account.

Timing: MUST BE IN THE NATIONAL OFFICE NO LATER THAN 30 DAYS AFTER THE FIRST GAME OF THE SEASON.