REGISTRATION PAGE

 

Select a Sport

 

Please select one sport. You will only have access to the sport selected. Once you have completed the Initial Level Clinic, you will have the option to add additional sport(s) to your membership by completing an Additional Sport Clinic at $5 per sport.

STEP 2 - Contact Information

 

Your password must be at least 6 characters long.

Nationwide offers our members exclusive discounts on auto insurance, as well as boat, motorcycle and RV policies. If you would like to receive a free quote from Nationwide, please select the check box and a representative from Nationwide will contact you with further details.
Nationwide Insurance
A proud supporter of NYSCA

Are you currently 18 years of age or older?

Are you currently a Nationwide Insurance policy holder?

Please select one or more of the insurance types below that interest you. The Nationwide representative will use your response to find products that fit your needs.
I authorize the Nationwide Family of Companies and its agents to contact me for sales and marketing purposes using live operators, automated telephone dialing systems, or prerecorded messages. I am not required to consent as a condition of purchasing goods or services. I may revoke this consent at any time.

STEP 3 - Chapter / League Affiliation

 

STEP 4 - Payment Information

If different, complete the form below:

The security code is on the back of Mastercard / VISA and on the front of AMEX.

You will have a chance to review your order before it is placed.