2019 Fall SU IRL Medal Request Form

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League Medals are available to order for teams competing in the Southern Utah Inter Regional League.

Only teams who have all their scores entered, games played, and in the proper standing of their division are eligible for medals.

Order limit is roster maximum and two coaches.
U9-U14 medals are available for first and second place teams only
U15-&up medals are available for first place teams only

To ensure that your team receives the correct amount of medals and placement, please fill out the form completely. Medals will be available for shipment starting October 19, 2019.

There is a $16 fee if you would like your medals shipped to you. Please call the state office to make your shipping payment.

Team Name (in Affinity) *

Team ID # (in Affinity ex. ) *

Boys/Girls *

Boys

Girls

Age Group *

U10

U11

U12

U13

U14

U15

U16

U17

U18

U19

Other:

Division (ex: Gold, Silver, Bronze) *

# of Players *

# of Coaches *

1 Coach

2 Coach

League Standing (** Age Groups U15 and older only qualify for first place medals**) *

1st

2nd

Email Address *

Phone Number *

How Will you receive your medals? *

I will pick them up from Terry Ogden

Please mail medals to my house. I will call the state office for payment.

If you would like your medals mailed to you, please fill out the mailing address and zip code below. Then call the UYSA State Office to pay the $16 postage fee. 801-307-5150

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