LEAGUE NAME:
ADDRESS:
LEAGUE AFFILIATION FEE:	$90	(Due September 1st each Year)
TEAM AFFILIATION FEE:	$15	Per Team (Due September 1st each Year)		Teams
PLAYER REGISTRATION FEE:	$10	Per Player		Players
PLAYER INSURANCE FEE:	$10	Per Player		Players
PLAYER PASS:	$4	Per Set Of Two (2) with Laminates		Sets
RELEASE FORM:	$3.50	Due Upon Receipt		Releases
COACHES PASS	$10.00	Each		C PASS
LEAGUE MEETING	$100			Bond
ATTENDENCE BOND
($25 per meeting - due to be paid or
replenished by Sept 1 of each year)				TOTAL DUE:	$          -
Send payment to:	EPSA
	2 Village Road
	Suite 1C
	Horsham, PA  19044-3816
For Administrative Use:
Check # _______________		Date Paid _________________________	Amount Paid _____________