Litchfield Youth Soccer League Travel Payment
Travel payment for the 2012-2013 season
Complete this form and the following PayPal forms to make a payment.
*
Required
PARENT / GUARDIAN INFORMATION:
*
First Name:
*
Last Name:
*
Phone:
E-mail:
PLAYER 1 INFORMATION:
*
First Name:
*
Last Name:
Select the player's team from the following list to register with that team.
Team Registration Fee:
Select Team When Registering
U08 Coed - Chris Wagner
U09 Girls - Troy Neily
U09 Boys - Mike Zimmerman
U10 Girls - Berit Keane
U10 Boys - Mike Boschi
U11 Girls - Mike Boschi
U12 Girls - Jason Rossi
U12 Boys - Zach Duprey
U12 Boys - Gus Barillas
U13 Girls - Allen Lajoie
U14 Girls - Jason Kohm
U14 Boys - Chuck LaBatt
U16 Girls - Allen Lajoie
$
Complete the following section to purchase a uniform for the player. A complete uniform is a white and red jersey, a pair of shorts, and a pair of socks. You can leave the sizes as ? if you are not sure of the size.
Jersey Size:
?
YXS
YS
YM
YL
YXL
AS
AM
AL
AXL
Red Quantity:
White Quantity:
$
Shorts Size:
?
YM
YL
YXL
AS
AM
AL
Quantity:
$
Socks Size:
?
Small
Med
Quantity:
$
Use the following entry to pay for something other than the standard registration fee or uniform costs. Use the comment section to provide any necessary details about this payment.
Miscellaneous Payment:
$
Sub-Total:
$
Comments:
PAYMENT:
Payment: $