SIPlive: River Heights - Misc Fees (L-)

River Heights City
T-Ball Registration

Registration begins April 1^stand closes when the spots are filled.

For boys and girls ages 3-5 (as of 6/1/18)
Games will be scheduled on Tuesdays and Thursdays during June at 5:30 or 6:30
Cost is $20 for River Heights residents and $25 for non-residents
Includes a t-shirt, hat and trophy
Coaches are needed - no prior experience needed

Parent/Guardian Information

First Name:	Last Name:
Address:
Address:
City:	State/Province:	ZIP/Postal Code:
Phone:	Email:

You will receive a call from your child’s coach before the games start. Please enter an alternate phone number below, if available, to make it easier on our coaches to contact you.

Alternate Phone Number

Parents/Guardians: We are in need of coaches and assistants for this year.

Are you willing to be a coach?

Are you willing to be a assistant?

River Heights Resident:

$20.00

Quantity:

Item Subtotal:

$0.00

Participants Full Name	[1]
Teammate Requests	[1]
Age of Participant as of 06/01/2018		[1]
Medical conditions this participant may have. N/A if none		[1]
Participants Full Name	[2]
Teammate Requests	[2]
Age of Participant as of 06/01/2018		[2]
Medical conditions this participant may have. N/A if none		[2]
Participants Full Name	[3]
Teammate Requests	[3]
Age of Participant as of 06/01/2018		[3]
Medical conditions this participant may have. N/A if none		[3]
Participants Full Name	[4]
Teammate Requests	[4]
Age of Participant as of 06/01/2018		[4]
Medical conditions this participant may have. N/A if none		[4]
Participants Full Name	[5]
Teammate Requests	[5]
Age of Participant as of 06/01/2018		[5]
Medical conditions this participant may have. N/A if none		[5]

Non-River Heights Resident:

$25.00

Quantity:

Item Subtotal:

$0.00

Participants Full Name	[1]
Teammate Requests	[1]
Age of Participant as of 06/01/2018		[1]
Medical conditions this participant may have. N/A if none		[1]
Participants Full Name	[2]
Teammate Requests	[2]
Age of Participant as of 06/01/2018		[2]
Medical conditions this participant may have. N/A if none		[2]
Participants Full Name	[3]
Teammate Requests	[3]
Age of Participant as of 06/01/2018		[3]
Medical conditions this participant may have. N/A if none		[3]
Participants Full Name	[4]
Teammate Requests	[4]
Age of Participant as of 06/01/2018		[4]
Medical conditions this participant may have. N/A if none		[4]
Participants Full Name	[5]
Teammate Requests	[5]
Age of Participant as of 06/01/2018		[5]
Medical conditions this participant may have. N/A if none		[5]

Total:

$0.00

By clicking the box below you acknowledge that you have read and agree to the statements included in the Waiver and Release of Liability and the Parent/Athlete Concussion Information.
Please open each document by clicking below.

Waiver and Release of Liability

Parent/Athlete Concussion Information Sheet

Parent/Guardian

I have read and agree to the statement above.

Please be aware that card payments will reflect on your statement

as CityFee 800-764-0844 Clinton UT!!

Payment Information

Method of Payment:

Convenience Fees:

Credit cards: 3% plus $0.25 ($1.50 min)
(+1.5% convenience for foreign cards)
eChecks: $0.49

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Bank Routing Number:
Bank Account Number:

Credit Card Number:
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Card ID (CVV2/CID) Number:	What is the Card ID?

Cardholder Information (exactly as it appears on your statement)
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Billing Street:
Billing ZIP/Postal Code:


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