Peace Lutheran Athletic Association - PLAA - (St. Louis, MO)

Subscribe to our Newsletter

PLYB Saturday Morning Program K-2 Registration

PLEASE COMPLETE ENTIRE FORM AND CLICK THE "SUBMIT FORM" BUTTON AT BOTTOM OF PAGE.

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Phone:

Email:

Gender:

* Grade: (Select from List):

* Shirt Size:

* Please rate player's skill level:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

* Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

SPECIAL REQUESTS (NOT GUARANTEED)

Comments or Requests (ie: play for coach, with friend, relative, etc.):

PLYB PROGRAM VOLUNTEERS NEEDED

I am willing to volunteer to "Coach" a Team

I am willing to volunteer to "Help Coach" a Team

I am interested in additional ways I can assist with the PLYB Program

PAYMENT INFORMATION

I am mailing my $35 check payable to "Peace Lutheran AA"

I will drop my $35 check payable to "Peace Lutheran AA" in the Peace office

I need to make other arrangements for payment and will contact PLAA

You will receive notification from this system stating that your registration form has been submitted, however your PLYB Program registration is not confirmed until you receive an email verification from Peace Lutheran Althletic Association verifying all required information has been provided and your payment has been received.

* indicates required fields

OUR SERVICES

LOCAL SPORTS

ELITE

Peace Lutheran Athletic Association - PLAA

PLYB Saturday Morning Program K-2 Registration