Complete the form below, print a copy of the this form, click on the SUBMIT button, mail this form, a copy of your roster and a check in the amount of $245 for U09 to U11 teams and $255 U12 to U19 teams, payable to LEAGUES UNITED to:
LEAGUES UNITED
PO BOX 63145
PHILADELPHIA, PA 19114 - 0945
State Your Team is Registered in: PA DE NJ MD
Leagues United Affiliated League You Played in: Central Penn YSL Delco Soccer League Independent Girls Soccer League Intercounty Soccer League Philadelphia Area Girls Soccer League Philadelphia Department of Recreation UJSL
Your Club's Name:
Your Team's Name:
Your Team's Age Group: U09 U10 U11 U12 U13 U14 U15 U16 U17 U19 Your Team's Gender: Boys Girls
Contact Person's Name:
Contact Person's Phone:
Contact Person's Cell Phone:
Contact Person's Email Address:
NOTES:
1. Fees must be received within 7 days of the application being submitted
2. Completing the application does not imply acceptance. Acceptance is approved with reception of check
Please print this page before clicking submit!