Fall 2023 Youth Player Acceptance
Monthly Payments

Fall 2023 Youth Player Acceptance Form 12U-14U - MONTHLY PAYMENT

Pay in 4 monthly payments of $386.25 (includes a 3% credit card fee for monthly payments). Payments will automatically be withdrawn from your card on file each month until the 4 payments have been completed. If you wish to pay the full fall 2023 season payment of $1,500 up front and save the 3% credit card fee please fill out the Full Payment form.

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*** Payments will automatically be deducted from your card on file each month for 4 months.
Please select a quantity of 1
Credit Card(Required)
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Expiration Date