2010
Senior League
Current Grade

9th
10th
11th

Lake League

P.O. Box 536
Havertown, PA 19083
(Complete Application, Print, Sign & Mail)
Did you play in the 2009 Billy Lake League?
Yes
No
Name:
Phone:
Address:
 Email:
City:
 School:
State:
 Zip: Height: Position:
2010 Billy Lake Senior League Fee:
$65.00

This year's Billy Lake ALS Marathon will be played on Saturday, June 12 at Monsignor Bonner High School. There will be a Senior League Marathon Game on Saturday, June 12 at 6 PM. The cost per player is $25.00 (tax deductible donation) which can be added to this registration. If you are interested in playing, just add $25.00 to this registration. All proceeds benefit research to find a cure for ALS. Thank you!

 
Yes, I would like to participate in the Senior League Marathon Game on Saturday, June 12 at 6 P.M. (Add $25.00):
No, I cannot play but I would like to make a donation to the Billy Lake ALS Marathon:
Total:

Make Checks Payable To: The Billy Lake Memorial League

Note: Applications will not be accepted if the form is not complete, player quota is reached in your division, Registration Fee is not included, and the Player/Parent signature is missing. All players who participated last year are reinstated if the application is received by February 28, 2009

Waiver

We acknowledge that the above information is true and that any falsification will result in dismissal from the league without refund. We acknowledge that the Township of Upper Darby , the School District of Upper Darby , the Billy Lake League, its Directors and Referees are not responsible for any physical injury that occurs during a sanctioned game. It is the responsibility of the players and parents to maintain adequate medical insurance. We waive and hold harmless the above mentioned for any damages or injuries that may occur during a sanctioned game.

Player Signature:

___________________________________________
  

Parent Signature:

___________________________________________ Date:____________

2010Billy Lake ALS Events

Friday, February 5th - Annual Billy Lake Beef and Beer
Friday, June 11 & Saturday, June 12 - 19th Annual Billy Lake ALS Marathon

For more information, please check our website at www.billylake.com