Hershey Intramural Sports Registration

HIS Registration

  • Player/Child's Information

  • Date Format: MM slash DD slash YYYY
  • Parent/Guardian Information

  • Emergency Contact Information

    In case of emergency you hereby give permission for us to contact the following person if you can’t be reached:   
  • Indicate your preferred medical provider (if any): 
  • Volunteer Positions & Information

    By submitting this Registration Form, both you (as the parent or legal guardian of your child) and your child are joining the Hershey Intramural Sports (HIS) Program. And we hope you will volunteer and participate to help make it a success!
  • Registration Fees

    Registration Admin fee is $5 (one time yearly Fee) plus $25 per month for Sunday Clinics The monthly fee is due on 1st Sunday of the Month. Additional players in your family are $20 each with a maximum fee for all registrations of $50 per family. Refund Policy - Your signature and receipt of payment constitute you and your child’s commitment for your child to play in the Hershey Intramural Sports program. No refunds will be issued. All participates must signed registration form and waiver form to play. Cash or a check made payable to: LM Hershey Intramural Sports, 1525 Sand Hill Road, Hummelstown, PA 17036. Feel free to contact his@lancastermennonite.org or clingergg@lancastermennonite.org with any questions, Or 717-443-9776.
  • Participants must purchase HIS basketball jersey