Register

Player registration

In-person sign-ups

October 31 & November 7 · 3:00 PM – 5:00 PM

Brooks Field Park
50 South Road, Fort Myers, FL 33907

Questions? Call Richard Samson at 239-560-6994

Before you register

$25 registration fee per athlete — families and group homes can register several athletes, then pay once at the end.
Doctor's note required — a signed note clearing each athlete to play must be turned in before the start of the season.

Questions? Call Kathy Samson at 239-267-2417.

Who are you registering?

I am registering myself I am registering others — guardian or group home

Athlete

First name *

Last name *

Date of birth *

Age

Athlete email

Optional. Athlete’s own email if they have one (separate from guardian contact).

Athlete phone

Optional.

Shirt size

Pants size

Male or Female *

New or Returning Player *

Guardian / group home contact

Use the same email for every athlete in your household or group home so they share one Team Portal login.

Guardian or staff name *

Relationship

Email *

Cell phone

Contact person home phone

Other contact number (cell)

Address

Address line 2

City

State

ZIP

Emergency contact

Name

Phone

Support & accommodations

Tell us anything that helps your athlete have a great season.

Doctor's release *

A signed doctor's note clearing the athlete to play must be turned in before the start of the season.

Need an assistant? *

Accommodations & preferences

Medical notes (allergies, conditions)

Eligibility

Do you have insurance? *

Has the participant had a criminal background? *

Player registration

In-person sign-ups

Before you register

You are registered!