Spring Intramural Program Registration Form

Thank you for your interest in the LMSC Spring Intramural Program. Please register your child in the form below. If there is a coaching volunteer associated with this child, please register that person below in the Coaching Volunteer section.

Child's Last Name*

Child's First Name*

Address*

Street Address City State ZIP Code

Phone*

Primary E-Mail Address*

Enter Email Confirm Email

Second E-Mail Address (Optional)

Enter Email Confirm Email

Parents' Names*

Gender

Male
Female
Other

Birthdate*

Spring Intramural Program

Please Select Appropriate DIvision*

Teammate Requests:
Players may list up to 3 teammate requests. LMSC will do their best to place your child on the same team as these players. We cannot guarantee that we can do this, but we will try.

This does NOT apply to the Pee-Wees, Atoms or Neutrons Divisions since players are not placed on set teams for the season in these divisions.

Teammate Request 1:

Teammate Request 2:

Teammate Request 3:

COACHING VOLUNTEERS
LMSC is dependent on having parents volunteer to coach. Please consider being a coach for your child's team. We are always especially in need of parents volunteering to serve as head coaches in the 6-12 year old divisions.

Coaching Volunter's Last Name

Coaching Volunteer's First Name

Phone For Coaching Volunteer

E-Mail For Coaching Volunteer

Enter Email Confirm Email

Coaching Preference

Head Coach
Assistant Coach

PROGRAM PAYMENT
The cost of the Spring Intramural Program is $120 per player. The cost will rise to $150 on March 25 for the 6-12 year old divisions. This is the date we start to make team assignments and schedules. We will start to close out divisions shortly after that.

You may pay by check or by credit card. If you choose to pay by check (made out to LMSC), please mail your check to LMSC, Box 360, Bryn Mawr, PA 19010.

There is a 3.3% bank service fee for credit card registrations.

Payment Choice:*

Bank Fee*

Price: $0.00

Total Amount To Be Applied To Credit Card

$0.00

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Additional Comments

Please feel free to enter any additional comments here: