PDLQ 2024 Tackle Football Registration
SoCal Jr. All American Football
PLAYER NAME
*
First Name
Last Name
ADDRESS
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
BIRTHDAY
*
-
Month
-
Day
Year
Date
Athlete's Age AS OF 7/31/24
*
GRADE AS OF NEXT SCHOOL YEAR
*
GENDER
*
Please Select
Non Binary
Female
Male
WEIGHT
*
Shirt Size
*
Please Select
Youth XXS
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Shorts Size
*
Please Select
Youth XXS
Youth XS
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Shoe Size (please include "Youth/Child" or "Adult" + Size
*
JERSEY # (PLEASE LIST 3 CHOICES IN ORDER OF PREFERENCE)
*
IS THIS YOUR FIRST YEAR PLAYING TACKLE FOOTBALL?
*
Yes
No
IS THIS YOUR 1st YEAR with PDLQ?
*
Yes
No
DID A FRIEND REFER YOU?
Please list first and last name. This friend may receive a Refer-A-Friend bonus on or after August 1, 2024.
PARENT/GUARDIAN #1
*
First Name
Last Name
PARENT/GUARDIAN #1 PHONE
*
Please enter a valid phone number.
PARENT/GUARDIAN #1 EMAIL
*
example@example.com
PARENT/GUARDIAN #2
*
First Name
Last Name
PARENT/GUARDIAN #2 PHONE NUMBER
*
Please enter a valid phone number.
PARENT/GUARDIAN #2 EMAIL
*
example@example.com
EMERGENCY CONTACT
*
First Name
Last Name
EMERGENCY CONTACT PHONE NUMBER
*
Please enter a valid phone number.
EMERGENCY CONTACT'S RELATIONSHIP TO PLAYER:
*
PDLQ Roadrunners Registration - Please select one.
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2024 Registration - Plus 1 Full Fundraising Calendar - PAY IN FULL
$200 Registration + Mandatory Fundraising Calendar ($465+). Full calendar and funds to be turned in 30 days from day of registration. **Every athlete who completes a Fundraising Calendar will receive an exclusive PDLQ swag bag. Swag Bags will be handed out before the official start of season.**
$
200.00
2024 Registration - Calendar Opt Out - PAY IN FULL
$400 Registration - Athletes may Opt Out of completing a fundraising calendar. This option will not provide a free exclusive swag bag. However, swag bags may be able to be purchased separately as season approaches.
$
400.00
2024 Registration - Plus 1 Full Fundraising Calendar 2 - PAYMENT PLAN ($50 deposit)
$200 Registration + Mandatory Fundraising Calendar ($465+). Full calendar and funds to be turned in 30 days from day of registration. **Every athlete who completes a Fundraising Calendar will receive an exclusive PDLQ swag bag. Swag Bags will be handed out before the official start of season.** Select your payment plan option below. Bi-Weekly or Monthly Invoices. Last Invoice sent July 1. Payment in Full due by July 15, 2024.
$
50.00
2024 Registration - Calendar Opt Out 2 - PAYMENT PLAN ($100 deposit)
$400 Registration - Athletes may Opt Out of completing a fundraising calendar. This option will not provide a free exclusive swag bag. However, swag bags may be able to be purchased separately as season approaches. Select your payment plan option below. Bi-Weekly or Monthly Invoices. Last Invoices sent July 1. Payment in Full due by July 15, 2024.
$
100.00
Selecting a PAYMENT PLAN?
Equal Monthly Payments (Invoices sent by Email)
Equal Bi-Weekly Payments (Invoices sent by Email)
Email Address For Payment Plan Invoices:
example@example.com
Date
-
Month
-
Day
Year
Date
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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