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Teams
Schedule
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League Information
Pre-Pesach Camp
Contact
Registration
Registration is now open!
Please register on a computer not a phone
Participant Name
(Required)
First
Last
Grade When Season Starts
(Required)
Kindergarten-4 yr olds (Clinics)
Pre 1-A-5 yr olds
1
2
3
4
5
6
7
8
School
(Required)
YOSS (South Shore)
HALB
HAFTR
HANC
Har Torah
YKLI
Darchei
Other
Participant can play goalie?
(Required)
Yes
No
Please realize this is a season long commitment.
Has the participant played in the hockey league before?
(Required)
Yes
No
Parent #1 Name
(Required)
First
Last
Parent #1 Cell
(Required)
Parent #1 Email
(Required)
Parent #2 Name
(Required)
First
Last
Parent #2 Cell
(Required)
Parent #2 Email
(Required)
Home Phone
(Required)
Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Liability Agreement
(Required)
I agree
I acknowledge that my son assumes all risks of being injured while participating in the 5 Towns Sports League and I agree to hold the 5 Towns Sports League, it's officials, coordinators and all other staff, harmless from any liability, loss, or personal expense arising out of my son's participation in the league. I have read and agreed to the terms stated in this application.
By checking "I Agree" you agree and commit to all the policies in the above waiver
Photo/Video Waiver
(Required)
I agree
I am the parent and personal representative of the participant mentioned above, I authorize 5 Towns Sports/Flag Football/Soccer to use and disclose the camper's name, image, likeness, photograph, and voice (Identifying Information ) for all public relations and marketing purposes, and for the development of a client contact list, including through written and electronic communications and publications. I understand that the League is not providing or receiving any goods or services in consideration for its use and disclosure of the participants Identifying Information.
Registration Agreement
(Required)
I agree
The league cost is: $375 + $12 cc processing fee per child – after December 30th its $400 + $12 cc processing fee. There will be a form to pay with credit card after you complete this application form.
Checks can be made out to JSL. Checks can be sent to 930 Broadway, Woodmere, NY 11598
Zelle payments can be sent to 5townsjsl@gmail.com
I UNDERSTAND THAT MY APPLICATION WILL NOT BE PROCESSED UNTIL PAYMENT IS RECEIVED.
Please be aware all Registration Fees are Non Refundable
Payment Method ($12 Credit Card Fee)
(Required)
Credit Card
Cash/Check/Zelle
Cash/Check/Zelle Price
Price:
YOSS Special
Price:
Credit Card Price
Price:
YOSS Special
Price:
Date
Total
Credit Card
(Required)
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number
Expiration Date
Month
Month
01
02
03
04
05
06
07
08
09
10
11
12
Year
Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Security Code
Cardholder Name