ALIEF YOUTH ASSOCIATION

REGISTRATION APPLICATION - Spring 2008

_________ AYA Rep Date ______________

Player’s Last Name _________________________________ First Name _____________________________________

Address _____________________________________________ Apt. # ___________ City _______________________

Zip Code _______________ Home Phone ________________________ D.O.B. __________/__________/__________

Subdivision ___________________________ School __________________________ Grade ___________ Sex ______

Sport Baseball _________ Softball ________ Soccer ________

Division ___________ Age _______ Returner? _________ Team ______________

Shirt Size: Youth Small_____ Youth Medium_____ Youth Large_____

Adult Small_____ Adult Medium_____ Adult Lg_____ Adult X Lg_____ Adult 2X Lg_____

Mother’s Last Name _________________________________ First Name _____________________________________

Employer ________________________________________ Occupation ______________________________________

Work Phone _______________________ Home Phone _______________________ Cell Phone ___________________

E-Mail Address ____________________________________________

Father’s Last Name ________________________________ First Name ______________________________________

Employer ________________________________________ Occupation ______________________________________

Work Phone _______________________ Home Phone _______________________ Cell Phone ___________________

E-Mail Address ____________________________________________

Secondary Contact _________________________________ Phone ________________ Relationship ______________

*** Note to Parents ***

You have an obligation for concession duty during the regular season – NO EXCEPTIONS

I understand and agree to the concession stand duty requirement ____________ ( please initial )

AYA REP WILL COMPLETE THIS SECTION OF FORM

Fundraiser: Donation ($45) ______ Candy ($100) ______Received Candy _____________ (please initial)

Registration + ______________

Fundraiser + ______________

Discount - _______________ Sibling’s Name _______________________________________________

Total Due = _______________ Total Paid ________________ Net Due ________________ Scholarship Y / N

Check #___________________ TDL# _____________________________ Cash # ______________________