Fall 2023 Youth Player Acceptance Form 10U & 11U - MONTHLY PAYMENTS - Sibling Discount

INCLUDES 10% SIBLING DISCOUNT - Pay 4 monthly payments of $301.28 (includes 10% sibling discount). You monthly payments will be withdrawn from the credit card on file every month until your 4 months are paid.

Player Name(Required)
Parent 1 Name(Required)
Parent 2 Name
Player Address(Required)
MM slash DD slash YYYY
Please enter a number from 00 to 99.
Please indicate your first choice for a uniform number (00 to 99). We cannot promise you will get your first choice but we will do our best to get you the number you want.
Please enter a number from 00 to 99.
Please indicate your second choice for a uniform number (00 to 99).
Please enter a number from 00 to 99.
Please indicate your third choice for a uniform number (00 to 99).
Acceptance(Required)
Agreement(Required)
***PLEASE CHOOSE A QUANTITY OF 1 BELOW***. 4 monthly payments will be auto-withdrawn from your credit card on file each month until your 4 payments have been made.
Please select a quantity of 1
Credit Card(Required)
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date