Football League Registration Form

Football League Registration Form
Date Today
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Player Name
First NameMiddle NameLast Name
Date of Birth
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Name of School

Emergency Contact Information
Name of Emergency Contact
First NameLast Name
Phone Number
Area CodePhone Number
Address
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Relation to Athlete

Parental/Guardian Consent
Conforme
Name of Doctor
First NameLast Name
Clinic / Hospital
Waiver
I am fully aware that this sport activity may cause accidental injury to athletes. I likewise assume any and all possible risk that may cause injury, illness, or death arising to such activity. I hereby declare that I waive my right to pursue any and all claims against the Commission and the Organizing Committee of this event should in any case that the accident, injury, illness or death occurs in the course of any activity held by them.
Signature of Parent / Guardian
Clear
Name
First NameLast Name
Date Signed
MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Team Application Information