Fall 2022 MCSSA League Registration and Membership Dues

* Required Fields
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Fee: $2.00to cover cost of bank fees.
League Applicants:
 
Complete the following information to participate in any of the MCSSA leagues.
*First Name
*Last Name
*Birth Date
mm/dd/yyyy
Profession (former profession if retired)
*Phone Number
*Street Address
*City
*State
*ZipCode
*Email Address
*Emergency Contact Name
*Emergency Contact Relationship
*Emergency Contact Phone(s)
Preferred Position(s)
Playing Experience(only if you are a new to MCSSA)
Dates you are not available to play

John X. Supinski League: Monday Mornings (Men 70+, Women 40+)

Ross Emerson League: Tuesday/Thursday Mornings (Men 60+)

Co-Recreation League: Wednesday Mornings Men 60+, Women 40+

Ron Schell League: Friday Evenings (Men 50+)

 

Rain makeup for all morning leagues will occur on Fridays, as may some regular scheduled games.

League Requested
League Requested
League Requested
League Requested
Member Dues: $10 if not already paid thru 3/31/23
Note: Change Dues amount to $0 if you already paid it at Spring registration.
Donation to MCSSA
*
 The participant assumes all risks associated with participation in the above activities. MCSSA assumes no liability for injury or damages arising from participation in these activities. Due to the strenuous nature of some activities, MCSSA encourages each participant to consult his or her physician concerning fitness to participate in the program. The participant consents to emergency treatment. 

MCSSA Mission Statement

Enhancing opportunities for senior citizens to stay physically active, to reduce the risk of illnesses by participating in sports activities. MCSSA strives to assist seniors to remain independent, increase morale, camaraderie and self esteem, improving the quality and longevity of life.

PAYMENT OPTIONS       
Mail checks to: MCSSA 14 Galesville Ct - Gaithersburg MD 20878. 
Paying by credit card will process the payment through PayPal. A PayPal account is not required.
Please pay by credit card as it expedites registration.
Total Due:
$ 
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