2013 PREMIER LEAGUE APPLICATION
information is indicated by a red star *
Your Application is not complete until you fill in ALL
and click the Submit button at the bottom of this page
Primary Phone: *
$70 for all Players regardless of where they played during the
Fall 2012 season.
Amount of Check $*
Check # *
Check Date *
Please make your check payable to AYSO Region 9. Include your child’s name
(s) on the memo line.
Checks returned for non-sufficient funds will be subject to a minimum of
a $25 penalty. Your child(ren) will not be placed until restitution is made.
Refund requests will only be accepted though January
Return this Application to
1 to 3 copies of the completed application needs to be printed (1
copy for each Player you are applying for!). Mail the
application(s) and your check to:
AYSO Region 9
P. O. Box 4914
Thousand Oaks, CA 91359-4914
attn: Premier League
By typing in my initials here *
and Submitting this form, I acknowledge my understanding that AYSO Region 9
is run completely by volunteers and that, without volunteers there will be
no program for my child.
Returning this form does NOT exclude my child from consideration for an
I will provide a copy of my child's or children's birth certificate(s) if
they did not play in AYSO Region 9 during the Fall 2012 season. A copy can
be mailed in with this application.
DEADLINE FOR APPLICATIONS IS DECEMBER 5th, 2012
Check your work then Submit
1) Make sure that all information is correct and complete and that you
have initialed the box above.
2) Click the Submit button below to complete your application.
If your information was completed correctly, after
you click the Submit button you will see a
Print 1-3 copies of this page.