STEP 1 - Contact Information

 

Note: List all children participating in program.
One child per line and include last name
only if different than parent listed.

(USA)

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 PAYS

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 2 - Program Affiliation

Are you signing up for PAYS membership because it is required by your child's program?
Yes
No

 

STEP 3 - Payment Information

The PAYS is a part of the National Alliance for Youth Sports, a 501(c)(3) non-profit corporation under the Internal Revenue Code. Contributions are tax-deductible in accordance with applicable law. Because of laws governing the solicitation of charitable contributions in Massachusetts, Pennsylvania, Tennessee and the District of Columbia, we are not soliciting, and cannot accept, contributions from residents of any of those jurisdictions. You can further support our efforts in making youth sports safer and more enjoyable for children by adding a contribution to your membership.

$

If different, complete the form below:

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