This registration session will allow you to complete contact information, sign up for participation, and submit payment. Please read through each page carefully to ensure that all information is provided accurately. To complete registration through our secure site, please have your Visa, MasterCard, Discover, or checking account information available.
PLAYERS BIRTH CERTIFICATE
MEDICAL INSURANCE COMPANY AND PHONE NUMBER
MEDICAL INSURANCE POLICY NUMBER
MEDICAL INSURANCE GROUP NUMBER
PHYSICIANS NAME AND PHONE NUMBER
Please direct any questions regarding this registration to:
Phone: (209) 221-3851
Select an option to continue with the registration.