LCS LEAGUE GAME CHANGE REQUEST
PLEASE PRINT
All reschedule requests must be submitted no less than 10 days prior to the scheduled match to be considered.
Reschedule requests are not guaranteed and are subject to field and referee availability.
NAME:
REQUESTING TEAM:
DIVISION:
ADDRESS:
ZIP CODE:
PHONE: ________________________
EMAIL: _____________________________________
Requesting Team Manager or Coach’s Signature:
Did you get approval for these dates from your Opponent: Yes _______ No________
GAME NUMBER: ______________________
Original Match
Date
Age
Bracket
Requested Match
Dates
1.
Age
Bracket
Home Team
Include if Boys or Girls
team.
Home Team
Boys or Girls?
Opponent
Time
Opponent
Time
2.
THIS IS A RAIN OUT GAME REQUEST – NO FEE (Use only if not able to play on assigned date)
THIS IS AN ELECTED RESCHEDULE WITH $75 FEE PAID BELOW OR BY CHECK #_______
VISA #
EXP
CVV
M’CARD #
EXP
CVV
Payment must be made at the time of the request in order to be scheduled.
Please email form to [email protected]