INDEPENDENT CHURCH LEAGUE

 
     REGISTRATION FORM   
     
  Church Name   Phone   
  Address        
  City, State  Zip   
  Church Representative Signature (Required)_________________________________________________  
    Preferred Division    
 

(Softball 2012) 

(Volleyball 2011-2012) 

     (Dodgeball 2012) 

  
 

Team Information

 
  Coach Name  Email  
  Address    City, State  
  Phone (Day)    Phone (Night) 

Zip   
  Alt Coach Name   Phone    

 
   
  Click on the box for all the nights on which your team can play the sport of:   
    SUN MON TUES THUR FRI  
  (Softball)   
  (Volleyball)  
  (Dodgeball)  
     
  Indicate any specific dates on which your team cannot play:    
  Is this your teams first year in the league? 

 
  If you participated last year, what was the win-loss record? 

 
  Which division? 

League Suggested division?

(FOR ICL BOARD USE ONLY-LEAVE BLANK)

  
  Reason? 

 

  
  Submitted By (Name)  Today's Date    
               
  ICL Board Information Only (Leave Blank)
  *Amount Paid   $____________ Check #       ___________   Cash Amount $____________ Date____________  
     

Church Representative Signature? 

  YES   /  NO

 Team Roster/Waiver?          

YES  /  NO
  Youth Release Waiver? If Req'd

  YES   /  NO

 WSP Background Check (If req'd)   YES   /  NO  
   
  1) Coaches must have a completed WSP Background Check on file with the League if players or coach on the team is under 18 (Waiver) is req'd.   
  2) Review your information for accuracy, then click on PRINT and print a copy of your form for the League Secretary/Treasurer. Next, click on SUBMIT to send a copy to the Web Manager.  
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