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Online League Registration

* indicates mandatory field

*Manager's Name:

*Team’s Name:

*Home Shirt Color:

*Away Shirt Color:

*Address / City / Zip:

*Telephone (H):

Telephone (W):

*Email Address:

Fees: $50 per player.

U5 - U12: Minimum of 8 Players / Maximum of 12

Over 30s: Minimum of 7 Players / Maximum of 10

Payment to be made in full via Check, Cash or Credit Card at least 30 minutes before kick-off of first match.

Team Manager, Adult Players, or Parent/ Guardian - Must read and tick box below!

As a team manager, adult player or parent/guardian of a player, I have read and understand the

registration policies and procedures of Pro~Kix. I accept the responsibility as a participant or on his/

her behalf that the registrant indicated above will play according to the policies listed in the

registration procedures. Any participant to the contrary will be subject to removal from further

participation without refund in the current session. *

*Age Level:

*Number of Boys: *Girls:

You may get an error message after submitting your form, your completed form will be sent to us, and we will receive it as normal.