PDLQ Football 2025 Registration

PDLQ 2025 Tackle Football Registration

SoCal Jr. All American Football
PLAYER NAME*

First NameLast Name
ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
BIRTHDAY*

MonthDayYear
Date
Athlete's Age AS OF 7/31/25*
GRADE AS OF NEXT SCHOOL YEAR*
GENDER*
WEIGHT*
Shirt Size*
Shorts Size*
JERSEY # (PLEASE LIST 3 CHOICES IN ORDER OF PREFERENCE)*
IS THIS YOUR FIRST YEAR PLAYING TACKLE FOOTBALL?*

YesNo
IS THIS YOUR 1st YEAR with PDLQ?*

YesNo
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 NameLast Name
PARENT/GUARDIAN #1 PHONE*
Please enter a valid phone number.
PARENT/GUARDIAN #1 EMAIL*
example@example.com
PARENT/GUARDIAN #2 *

First NameLast Name
PARENT/GUARDIAN #2 PHONE NUMBER*
Please enter a valid phone number.
PARENT/GUARDIAN #2 EMAIL*
example@example.com
EMERGENCY CONTACT*

First NameLast Name
EMERGENCY CONTACT PHONE NUMBER*
Please enter a valid phone number.
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, 10Midget - Ages 11, 12, 13, 14

PDLQ Roadrunners 2025 Registration - Please select one. *

2025 Registration$400 Registration - PAYMENT IN FULL

$400.00

Enter coupon

Total

$0.00

Parent Name Responsible for Payment Plan (If Applicable):

First NameLast Name
Phone Number for Payment Plan Communications (If Applicable):
Please enter a valid phone number.
Email Address for Payment Plan Communications (If Applicable):
example@example.com
Date

MonthDayYear
Date

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

PDLQ 2025 Tackle Football Registration