top of page

Gender*

arrow&v

Player Name*

Player School*

Player Grade*

arrow&v

Player D/O/B*

Player Shirt Size*

arrow&v

Parent / Guardian Name*

Parent / Guardian Telephone *

Parent / Guardian E-Mail*

Player Insurance Provider / Policy

COVID-19 (no liability on Penn Playmakers / Facility) *

REGISTER BEFORE TUESDAY NOVEMBER 1ST 2022

ADAMSTOWN YMCA

71 E MAIN ST

ADAMSTOWN, PA 19501

REGISTRATION IS NOT COMPLETE UNTIL $85 FEE IS PAID 


NO REFUNDS





bottom of page