PYLA Registration 2020
Welcome to Palmyra Youth Lacrosse Association!  Upon completing this registration form, please mail your registration fee of $150 (make checks made payable to PYLA) to Ashley Harrison at 113 Woodlawn Avenue, Palmyra, PA 17078.  There is a $25 discount for each sibling that is registered.  Also, please make sure that your player has an updated US Lacrosse Membership, as this is a requirement to participate.  You can register for or update a US Lacrosse Membership at https://www.uslacrosse.org/membership.  Please contact Ashley Harrison with any questions at secretary@palmyrayouthlacrosse.org.

 

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Player's Name (first and last)
Player's Birthdate
Player's Address
Child's Grade
Child's School
Siblings Playing Lacrosse
US Lacrosse Membership Number
US Lacrosse Membership Expiration Date
Primary Parent's Name
Primary Parent's Phone Number
Primary Parent's Email
Secondary Parent's Name
Secondary Parent's Phone Number
Secondary Parent's Email
Jersey Size
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Shorts Size
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