League Fee: $80.00

(Includes shirt & supplemental insurance)

Registration Nights – Open Gym

Monday, March 07th 7:00 pm & Monday, March 14th 7:00 pm

 (Doors open at 6:30 pm)

First Game Day – Monday, March 21st

Registration is on First Come Basis with only 54 spots available.

If registering by mail, form & fee must be received by Friday, March 5th, 2021

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Date of Birth *

mm/dd/yyyy

Age *

Phone Number *

(###) ###-####

Email *

Emergency Contact *

Emergency Contact Number *

League Fees *

Price: $ 80.00

Includes shirt & supplemental insurance

Credit Card *

Card

Name on Card

Total *

$ 0.00

Submit