Rockwell Collins Futsal League
Winter 2017
- Registration Form -

About You:  * = Required entry.
 Please Note:  • To participate in Rockwell Collins Sports League activities, each registrant must comply with one of the following eligibility requirements: The individual must be a Rockwell Collins Employee or Spouse; an active Rockwell Collins Contractor or Spouse; a Rockwell Collins Retiree or Spouse; or currently a Member of the Rockwell Collins Recreation Center.
• Co-op Students are classified as employees.
• All active Rockwell Collins Contractors are eligible for Membership in the Recreation Center.
* Eligibility:
* First Name:
* Last Name:
 

* Office Phone:
* Home Phone:
* Emergency Phone:
* Emergency Contact:
* E-mail:
* Rec. Center: Are you also a member of the Rec. Center? Yes No

Skill Level:
Skill Level: 1 2 3 4 5 6
1 - 2 - 3, Low
Never played before,
limited experience.
4 - 5 - 6, Medium
Experienced, average ball skills,
endurance, & impact.
7 8 9 10
7 - 8 - 9, High
Competitive play experience,
above average skills.
10, Advanced

Ranking: List any info related to your basis for ranking, such as 'I've played in high school and/or college'.
* Basis:

Special Requests: Note… Special requests are not guaranteed!
Request:

Indemnity Agreement, Waiver and Release:
* Signed: I… with the above text, and submit my "Signature".
 
 
  ______________________________________________
Dated:September 21, 2017

Review & Submit: Important… Review your email address!
 
 Important Information  Business Address: Rockwell Collins Recreation Center, 800 Collins Road N.E., Cedar Rapids, Iowa 52498
Customer Service Phone Number: 319-295-2552
Return Policy: If you feel that you have been charged in error, please contact Mike Duffy at 319-295-2552 and if indeed there was an error, you will be refunded the full amount directly back to the card that you used for the transaction you are referencing.
Privacy Policy: Your personal information including your credit card information will not be shared with any other private party and is only used for the purposes of completing this transaction. Your card number is secure and not visible to anyone on staff.
Technical Contact: Larry Tjaden 319-365-8160 webmaster@rockwellcollinsclubs.com

Copyright © 2017 Rockwell Collins Clubs & Leagues • All rights reserved.