2019 Fall PL, SCL, IRL, X-League Medal Request Form

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League Medals are available to order for teams competing in the PL (BU16-U19), SCL, IRL, X-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 pick up or can be mailed to you 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.

All medals must be picked up by December 19, 2019

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

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 the UYSA office. (The UYSA office is located at 9159 S, State Street Sandy, UT 84070)

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

Your medals are available for pick up at the USYA office during business hours (9-5) starting October 19, 2019.

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