ACSA Player Membership Form

Adult Competitive Sports Association (ACSA)

Welcome to the Adult Competitive Sports Association.

This form collects the information necessary to activate your ACSA membership, which is required to participate in any ACSA-sanctioned league or event.

Annual Certification Fees:
• Single Sport Certification — $30

ACSA Player Membership Form

SECTION 1

Player Information

First Name*

Last Name*

Primary Email*

Date of Birth*

Primary Phone*

SECTION 2

Player Verification

Team Name*

League / City*

Example: Montgomery Basketball League

Captain / Coach Name

This helps ACSA confirm roster placement.

SECTION 3

Sport Participation

Sport*

SECTION 4

Emergency Contact

Emergency Contact Name*

Emergency Contact Phone Number*

SECTION 5

Membership Requirement

Signature Block

Signature

Signature Block

By submitting this application, I certify that the information provided is accurate and complete.