2013 Flag Football Registration - League Athletics
For Internal Use Only
Returning New
Vernon Hills Athletic Association www.vhycaa.org
2013 Flag Football Registration Player Information Last Name
First Name
Address City
Postal Code
Home Phone Number
Date of Birth
Neighborhood
School
Age of September 1, 2013
2013-14 Grade
Parent #1
□ Player Resides With
Gender
Parent #2
□ Player Resides With
Name
Name
Email Address
Email Address
Cell Phone Number
Cell Phone Number
□ Send Game/Practice Reminder Text Messages
□ Send Game/Practice Reminder Text Messages
Cell Carrier (AT&T, Verizon, etc)
Cell Carrier (AT&T, Verizon, etc)
Please List Any Potential Conflicts for the Season (Mid-August through October)
Emergency Contact & Medical Information Contact Name Medical Comments
Phone Number
Relationship
Flag Football Registration: Page 2
Player’s Last Name:
Previous Sport Experience
2011 Team
Uniform Size – Check One of Each
□ □ □ □ □
Positions
Jersey (CHEST) YOUTH XXS (22″–24″) □ ADULT S (34″–36″) YOUTH XS (24″–26″) YOUTH S (26″–28″) YOUTH M (28″–30″)
□ □ □
Jersey #
(this information is used as a guide when ordering for the 2010 season)
ADULT M (36″–38″) ADULT L (38″–40″)
□ □ □
T-shirt Size □ ADULT XS
YOUTH S
□ □ □ □
YOUTH M YOUTH L
ADULT S (40″–42″)
YOUTH L (30″–32″)
ADULT S ADULT M ADULT L ADULT XL
The information I provided regarding my son/daughter is correct.
Signature of Parent/Guardian
Date
2013 Fees K and 1st grade League: $125.00 2nd and 3rd grade league: $135.00 4th and 5th grade league $135.00 FOR OFFICE USE ONLY
PAYMENT INFO
Player ID No:
125.00/135.00 REGISTRATION FEE RECEIVED BY
Check # DATE
Cash
Returning New
Vernon Hills Athletic Association www.vhycaa.org
2013 Flag Football Registration Player Information Last Name
First Name
Address City
Postal Code
Home Phone Number
Date of Birth
Neighborhood
School
Age of September 1, 2013
2013-14 Grade
Parent #1
□ Player Resides With
Gender
Parent #2
□ Player Resides With
Name
Name
Email Address
Email Address
Cell Phone Number
Cell Phone Number
□ Send Game/Practice Reminder Text Messages
□ Send Game/Practice Reminder Text Messages
Cell Carrier (AT&T, Verizon, etc)
Cell Carrier (AT&T, Verizon, etc)
Please List Any Potential Conflicts for the Season (Mid-August through October)
Emergency Contact & Medical Information Contact Name Medical Comments
Phone Number
Relationship
Flag Football Registration: Page 2
Player’s Last Name:
Previous Sport Experience
2011 Team
Uniform Size – Check One of Each
□ □ □ □ □
Positions
Jersey (CHEST) YOUTH XXS (22″–24″) □ ADULT S (34″–36″) YOUTH XS (24″–26″) YOUTH S (26″–28″) YOUTH M (28″–30″)
□ □ □
Jersey #
(this information is used as a guide when ordering for the 2010 season)
ADULT M (36″–38″) ADULT L (38″–40″)
□ □ □
T-shirt Size □ ADULT XS
YOUTH S
□ □ □ □
YOUTH M YOUTH L
ADULT S (40″–42″)
YOUTH L (30″–32″)
ADULT S ADULT M ADULT L ADULT XL
The information I provided regarding my son/daughter is correct.
Signature of Parent/Guardian
Date
2013 Fees K and 1st grade League: $125.00 2nd and 3rd grade league: $135.00 4th and 5th grade league $135.00 FOR OFFICE USE ONLY
PAYMENT INFO
Player ID No:
125.00/135.00 REGISTRATION FEE RECEIVED BY
Check # DATE
Cash
