Club/Team Information
Club Name:
Team Name:
CDYSL Division: (ie: U16B1 [Red]- be specific if known
Tourney Division:		Boys    Girls
Level: CDYSL div 1 or 2 = "A", CDYSL div 3,4,5 = "B"		A    B
Your Age Group Choice:		(You can use this area -to play in a higher age group or leave a short note)
Coach Information
Coach's Name:
Address:
City:
State:		Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip Code:
Email Address:
Contact Information:
Name:
Address:
City:
State:		Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip Code:
Email Address :
Phone Number (Day):
Phone Number (Night):
Billing Information: (If paying by credit card, this must match address your statements come to)
First Name:
Last Name:
Address:
City:
State:		Alaska Alabama Arkansas Arizona California Colorado Connecticut District of Columbia Delaware Florida Georgia Hawaii Iowa Idaho Illinois Indiana Kansas Kentucky Louisiana Massachusetts Maryland Maine Michigan Minnesota Missouri Mississippi Montana North Carolina North Dakota Nebraska New Hampshire New Jersey New Mexico Nevada New York Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Virginia Vermont Washington Wisconsin West Virginia Wyoming
Zip Code:
Amount To Charge: (on/before 3/25/23)		$325: U8-10 $350: U12 $400: U14 $500: U16 & Above
Payment Method:		Check    Credit Card (via Paypal)
Check Number (if paying by check): * If you paying with a check/MO (money order) and don't have one in your possession at this time, just type 999 in this space. Please mail payment within a week of registering and make sure a phone number is on your payment. Make your check or money order payable to: RUSC Mail your payment to: RUSC c/o Bob DiBella 2048 Careleon Rd - Schenectady, NY 12303 Thank you!