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2024 Codger Player Registration Form
Make sure to hit the Submit Button after you fill in the entire form!:
*
Please select League:
Morning League (Monday-Wednesday)
Evening League (Tuesday-Thursday)
Both Leagues
*
Team you were on last year or This year if up dating info or if none just put none:
*
First Name:
*
Last Name:
Home Phone:
Cell Phone:
Work Phone:
*
Email (Home):
:
Email (Work):
Street Address:
City:
State:
Zip Code:
Birthdate:
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Age as of 12-2024:
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Year started in League:
2026
2025
2024
2023
2022
2021
2020
2019
2018
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2016
2015
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*
Shirt Size:
*
Shirt # for Back of Shirt 2 digits only:
Comments / Questions:
Wife's Name:
Significant Other's Name:
MEDICAL/EMERGENCY CONTACT INFORMATION
Emergency Contact:
Phone:
Relationship to Player:
Insurance Carrier:
Policy #:
*
I WILL BE PLAYING IN 2024?:
YES
NO
After answering Y/N, please hit the submit button to send. If you do this correctly you will get a message that it was sent to Bart Neckers
* indicates required fields