Youth Sports Registration

Please complete the following form to register for this YMCA program.

Registration:	February 1 - March 3
Games Begin:	March 18 (Boys), March 20 (Girls)
Fee:	$400 per team (t-shirts not included)
Location:	63 Sports Complex

Each coach will be provided a waiver that must be signed by each parent/guardian in order for the team to be accepted.

Please note the following:

Registration is not final until you are contacted by a YMCA employee to confirm your information is correct and that there is space available in the class/program.
All items marked with an asterisk (*) must be filled out to complete your registration.
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Security

Select Sport

Youth Sports

Please select your sport. You must regsiter within the proper timeframe for each sport.

Coach Information

Please enter the following information about the team and coach.
* First Name:
* Last Name:
* Street Address:
* City:
* State:
* Zip:
* Home Phone:	( ) -
Cell Phone:	( ) -
Work Phone:	( ) -
* Email Address:

Coach Information

Please enter as much information as possible. The coach will serve as the primary contact for the team.

Players Information

Please enter the following information for each player on the team.
Player Name	Phone	Grade
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Players Information

Each coach will be provided a waiver that must be signed by each parent/guardian in order for the team to be accepted.

Credit Card Information

Your credit card will be charged the appropriate rate listed at the top, based on the session and YMCA membership.
* Credit Card Type:
* Credit Card Number:	- - -
* Credit Card Verification Number:	(On back of credit card)
* Expiration Date:	/
* Name on Credit Card:
If you do not wish to register with a credit card online, please print off form and mail in with payment. You can also register at the front desk at either YMCA location.

Credit Card

You must complete all information for us to process your online registration.