Name *

First Name

Last Name

Phone

(###)

###

####

What sports do you want to register for: *

Volleyball

Basketball

Futsal

Flag Football

Tennis

What are you? *

Free Agent

Registering Team

Participation in Fall Rec Leagues is a paid event. Please select how you would like to pay for this event: *

If registering for a team let me know if they want payroll deduction as well.

Payroll Deduction. By selecting this option you are authorizing Texins to proceed with a $15 for Texins members or $35 for non-members payroll deduction charge.

Credit Card

Would you like to receive future communication about recreation leagues? *

Yes

No