League22 Registration Posted December 30, 2014 by Matthew Athlete Name* First Last Athlete Age*Please enter a value between 5 and 20.Athlete Grade*Please enter a value between 1 and 12.Athlete SchoolParent/Guardian Name* First Last Phone*Email* Emergency Contact First Last Emergency Phone2019 Leagues Price: $125.00 Season*Winter League Session: Jan 6-Feb 10Total $0.00 Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20182019202020212022202320242025202620272028202920302031203220332034203520362037 Expiration Date Security Code Cardholder Name Accept Terms and Conditions* I agree to the terms and conditions below. I, the parent/guardian listed above, give permission for the named athlete to receive emergency medical or surgical treatment and hospitalization if necessary. I understand that every attempt will be made to contact me, or the emergency contact named above, before taking this action. I will be financially responsible for any medical attention needed during training/camps/leagues or resulting from an injury received at training/camps/leagues. This iframe contains the logic required to handle Ajax powered Gravity Forms.