Deerfield Park District League Application Form I.
Please fill in/check appropriate information Sport: Day Requested: Competition Level:
II.
Men's: Women's: Co-Rec: Open:
Adult: High School:
Please check items that apply to your team Returning Team:
Team information if returning team:
New, Resident:
Team Name:
New, Non-Resident:
Season played:
III. Team & Captain Information for ______________ Season
Activity # Section #
Team Name: Captain's Name
Home Phone:
Address:
Work Phone: Cell Phone:
Most communication is through e-mail. A clearly printed e-mail address is very important.
E-Mail Address: IV. All awards and forfeit fee refunds will be sent to the CAPTAIN listed above. The team captain must pay the $50 deposit for league registration. Any team sponsor may pay the rest of the league fee. V.
Requirements: 1. Application Form 2. League Deposit/forfeit fee (required for registration) $50 3. League Fee (optional for registration…balance due by Captain's meeting) $ 4. Amount you are paying now $ 5. Team waiver/roster (team/league information, names, addresses, signatures) Roster for returning teams due by Captain's meeting Roster for new teams due with application Employment verification letter due with roster for new, resident, corporate teams
VI. Acceptable forms of payment include: cash, check or charge (Master Card, Visa, Discover)
Credit Card #
Signature of person completing this form: Exp. Date:
VII. Drop off or mail to: Deerfield Park District 836 Jewett Park Drive Deerfield,IL 60015
Phone: (847) 945-0650 FAX (847) 945-0699