Your Name
*
First Name
Last Name
Contact Phone Number
*
-
Area Code
Phone Number
Contact Email
*
example@example.com
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Player's Name
*
First Name
Last Name
Player's Current Grade in School
*
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
Player's Team Coach (Put N/A if unkown)
*
Player's Current School
*
Player's Gender
*
Male
Female
Comments - please put the grade level of the team you are paying for in this section, along with any other information we should know.
Upon completing this form you will be taken to an online payment page to pay the $100 Uniform Deposit.
Proceed to Payment
Should be Empty: