NCAAU TACKLE FOOTBALL 2017 Registration Form CONFERENCE ...
NCAAU TACKLE FOOTBALL 2017 Registration Form CONFERENCE NAME:______________________________________ CLUB NAME:______________________________________________ Please select one: Football_____ Cheer____ Refund Policy: Check with your individual Club or organization. **Please Print** Participant’s Name:_____________________________________________________ Date of Birth: ____________________________ Age as of 8/1/2017: _____________ School Attending this Fall:_________________________________________________ Was participant promoted to next grade? Yes____ No____ Was participant part of a different AAU Tackle Football Association last season? Yes___ No___ Father/GuardianName:__________________________________________________ Address: ______________________________________________________________ City: ____________________________ State:________ Zip Code:________________ Home Phone: _____________________ Cell Phone: ___________________________ Email Address:__________________________________________________________ (Email is used for team purposed only – no sold or shared)
Employer:______________________________________________________________ Mother/Guardian Name: _________________________________________________ Address: ______________________________________________________________ City: ____________________________ State:________ Zip Code:________________ Home Phone: _____________________ Cell Phone: ___________________________ Email Address:__________________________________________________________ (Email is used for team purposed only – no sold or shared)
Employer:_____________________________________________________________________________________________ Insurance Carrier: Policy Number: By signing below you release AAU, NCAAU Tackle Football, your above Club and Conference, from any and all liabilities associated with injury through participation in this program.
Parent/Guardian Signature: ___________________________ Date: _______________ Participant’s Signature:_______________________________ Date:________________
Official Use Only: Date: __________________ Total Due: ___________
Discount Applied: ________________ Balance Due: ____________________
Employer:______________________________________________________________ Mother/Guardian Name: _________________________________________________ Address: ______________________________________________________________ City: ____________________________ State:________ Zip Code:________________ Home Phone: _____________________ Cell Phone: ___________________________ Email Address:__________________________________________________________ (Email is used for team purposed only – no sold or shared)
Employer:_____________________________________________________________________________________________ Insurance Carrier: Policy Number: By signing below you release AAU, NCAAU Tackle Football, your above Club and Conference, from any and all liabilities associated with injury through participation in this program.
Parent/Guardian Signature: ___________________________ Date: _______________ Participant’s Signature:_______________________________ Date:________________
Official Use Only: Date: __________________ Total Due: ___________
Discount Applied: ________________ Balance Due: ____________________
