Want to become a member of SLSL?

Parent Information Only - (do not enter Player information here).

Please read ALL information on this and the next page.

First:

Last:

Nickname:

(Leave blank if no Nickname)

Street:

Apt:

City/State/Zip:

Development:

Classification:

	Lives in Southern Lehigh
	Lives outside Southern Lehigh

Home Phone:

ex: 111-222-3333

Primary Email:

Only enter a single valid email address. Once you have received your username/password you will be able to enter additional email addresses.

Verify Email:

Retype the same email address.