2018 PLAYER REGISTRATION

PLAYER INFORMATION

PARENT/GUARDIAN #1

PARENT/GUARDIAN #2

MEDICAL/EMERGENCY CONTACT INFORMATION

WAIVER INFORMATION
I understand I will still need to complete the player contract and supplemental sign up form.

I understand registration is not complete until payment is received.

Payment plans are available:
$100 non-refundable deposit required. Remaining registration fees of $150 must be paid in full before the 1st day of practice. No exceptions.

Payment can be made in person at all sign up locations, paid online or mailed to
PDLQ PO BOX 6198 La Quinta CA 92248.
A $5.00 processing fee has been added for all credit card payments.

I understand all refund requests must be submitted in writing to the board. Full refund requests must be submitted before July 1st. After July 1st $100 of my registration fee is a non refundable deposit. The remaining balance may be requested as a refund through August 1st. No refunds after August 1st. **Extenuating circumstances will be considered by the board**

I understand that all players must have a physical before they may begin practice. Medical forms may be found under handouts.


* required


Payments Accepted By

Note: Credit Card information can be entered once this form is submitted