PDLQ 2025 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 7/31/25
*
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
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, 2025.
PARENT/GUARDIAN #1
*
First Name
Last Name
PARENT/GUARDIAN #1 PHONE
*
Please enter a valid phone number.
Format: (000) 000-0000.
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.
Format: (000) 000-0000.
PARENT/GUARDIAN #2 EMAIL
*
example@example.com
EMERGENCY CONTACT
*
First Name
Last Name
EMERGENCY CONTACT PHONE NUMBER
*
Please enter a valid phone number.
Format: (000) 000-0000.
EMERGENCY CONTACT'S RELATIONSHIP TO PLAYER:
*
Please Select Team Preference - Final Placements will be made by the Chapter AD. If we have any questions regarding your preference we will reach out after submission. Jr. Micro team and Jr. Peewee teams are full. All Teams are FILLING - register today and tell your friends too.
*
Micro - Ages 8, 9, 10
Midget - Ages 11, 12, 13, 14
PDLQ Roadrunners 2025 Registration - Please select one.
*
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2025 Registration
$400 Registration - PAYMENT IN FULL
$
400.00
Parent Name Responsible for Payment Plan (If Applicable):
First Name
Last Name
Phone Number for Payment Plan Communications (If Applicable):
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address for Payment Plan Communications (If Applicable):
example@example.com
Date
-
Month
-
Day
Year
Date
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
Submit
Should be Empty: