2018 Fall JBL Adaptive Sports Player Registration Information Form
Thank you for registering for Jacob's Buddies League Adaptive Sports Program.
Please provide the information below so we can prepare for our upcoming season.
Please Note: You will be directed to our partner Liverpool FC IAA Bay Area website upon submission of this registration form to complete your secure payment.
I understand that my player's registration in the program is not complete until I submit payment.
Player's First Name
NOTE: We will use this name for any printed items like certificates, etc.
Player's Last Name
Player's Nickname/Preferred Name
What does your player preferred to be called on the field?
Player's T-Shirt Size
Player's School (2018-19 School Year)
Player's Grade in School (2018-19 School Year)
Select One . . .
(ex: 123 Main St., San Jose, CA 95120)
Player living with:
(Please choose one)
Both Parents in one household
Both Parents in separate households (add Secondary Household Address)
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