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Inspire. Unite. Educate. Grow the Game.
2015 Outdoor Youth Leage @ Cato Park Registration Form
Please complete form and return to:
Quantum Sports Center
3548 Teays Valley Road
Hurricane, WV 25526
or
[email protected]
or
fax 304- 562-3689
$55 per player
Age Group (circle one)
U8 Co-ed
U10 Girls
U10 Co-ed
U12 Girls
U12 Co-ed
Middle School Co-ed
High School Co-ed
Player Name ______________________ _________________________________
Contact Name _____________________________ ___Home Phone ____________________
Work Phone___________________________________
Contact address
_____________________________________________________________________________
Cell phone____________________ email __________________________________________
All FIELDS ARE REQUIRED
*The league committee reserves the right to combine or split divisions as needed according to age.
Please sign below to indicate you understand our policy.
Contact name signature
x_________________________________
Please include any additional information that will be helpful in the process.
Cody Freas- League Coordinator
Cody Freas - [email protected]
Quantum Sports Center 304-562-1020
Deadline for Application is 6/01/15
For office use only
Date Received:____________
Amount of Check __________
Check #________
Locations in Hurricane and Kanawha City
304-562-1020
www.quantumsportscenter.com