north penn athletic association squires 2017 registration
NORTH PENN ATHLETIC ASSOCIATION SQUIRES 2017 REGISTRATION
☐TACKLE FOOTBALL
☐FLAG FOOTBALL
☐ RECREATIONAL CHEERLEADING
Participant Name
Date of Birth
Address City
State
Telephone (Home)
Zip Code
Telephone (Cell)
Email Address Years in Squires Football/Cheerleading incl. 2017
Grade 2017/18 School Year
REGISTRATION FEES: Please Make Check Payable to “NPAA” and mail with this form to the address at the bottom or you may also register online at www.northpennsquires.com. (Capped at $350 per same family)
Flag/Cheer
By May 31th : $90
By May 31th : $125
After May 31th : $110
Tackle
After May 31th : $150
Tackle Jersey: $35
Tackle Players---List Top 3 Jersey Numbers---Choice #1 Flag Player T---Shirt Size_ Cheerleader Sweatshirt Size
Choice #2
Choice #3
Equipment Agreement: Equipment care & return is the responsibility of the parent or guardian of the players. All equipment must be returned in the same condition received with the exception of normal wear. A check of $150 per cheer/football player is expected at the time of equipment handout and will be returned at the end of the season. Certain personal items i.e. football cleats, athletic supporters, game socks and cheer accessories are not included but may be required. The tackle football players will need to purchase a personalized football jersey with the last name on the back.
MANDATORY FUNDRASIER: Each family is responsible for selling 3 Football Mania tickets totaling $60, which will be collected during equipment handout. Cancellation Fee: $25 through August 30, 2015. No refunds after August 30, 2015. All equipment must be returned before any monies refunded.
Parent/ Guardian Information Father’s Name Mother’s Name Guardian’s Name (If different from Father and/or Mother)
P.O. BOX 1213 * NORTH WALES, PENNSYLVANIA 19454 * (215) 362 ---5970 WWW.NORTHPENNSQUIRES.COM
NORTH PENN ATHLETIC ASSOCIATION REGISTRATION PAGE 2
VOLUNTEER INFORMATION: The NPAA is a volunteer non---profit organization. Parent participation is mandatory. Parents are expected to participate in volunteer activities during the season--- approximately 5 hours. (your initials) Everyone will be obligated to perform some volunteer duties such as snack stand, field crew (down markers, raffle tickets, half time snack, etc.) (your initials). Listed below you will find various ways to volunteer. Please CIRCLE at least one area in which you have an interest & are committed to help. Football Coach Building & Grounds First Aid/Medical Field Maintenance
Team Parent Communications/Photo Fundraising Beef N Beer
Snack bar Sponsorship Equipment
Cheering Coach Banquet Website
My son/daughter has my permission to participate in the Football/Cheerleading program of the North Penn Athletic Association for the 2015 Season. I understand that participation in athletic competition, as well as practicing for athletic competition, involves hazards and risks of personal injury, including but not limited to fractured bones, lacerations, and damage to the nerves and nervous system, some of which may be serious and/or permanent in nature. I recognize that I have the right to inspect the condition of all equipment, playing surfaces and related facilities prior to use of the same, and to have my son or daughter refrain from participation in the event of any defects or hazards. I assume all risk and hazards to such participation including transportation to and from activities. I hereby waive, release, absolve, indemnify, and agree to hold harmless the officers, managers, directors, and coaches of the North Penn Athletic Association from any claim arising out of an injury to my son/ daughter.
I further understand that the North Penn Athletic Association will not provide accident insurance of any kind and I am solely responsible for any medical and surgical bills which result out of an injury which may arise from my son’s/daughter’s participation in any of the programs of the North Penn Athletic Association. I am solely responsible for equipment assigned to my son/daughter and will return said equipment at the completion of the season or as requested by the association. If I fail to return all equipment issued, I understand that I must reimburse the North Penn Athletic Association $150 per football and cheerleading uniform. I understand that my child will not be able to participate until financial commitments have been met. I understand failure to sign this form will result on the disqualification of my child from further participation in the 2015 football season and I will not be entitled to any refund of registration, uniform, and/or fundraising fees. I understand that I am responsible for my child’s behavior while my child is at practice, games, and any other NPAA sponsored activities.
Parent Name Parent Signature
Date
ACCIDENT INSURANCE INFORMATION Insurance Company I.D. #_
GROUP #_
REGISTRATION AND/OR UNIFORM FEE
☐
PAID BY CHECK
CHECK #_______________
❑
PAID BY CASH
☐
AMOUNT PAID__________________ DATE_____________
PAID BY CREDIT CARD
“BETTER SPORTSMEN TODAY, BETTER CITIZENS TOMORROW”
P.O. BOX 1213 * NORTH WALES, PENNSYLVANIA 19454 * (215) 362 ---5970 WWW.NORTHPENNSQUIRES.COM
☐TACKLE FOOTBALL
☐FLAG FOOTBALL
☐ RECREATIONAL CHEERLEADING
Participant Name
Date of Birth
Address City
State
Telephone (Home)
Zip Code
Telephone (Cell)
Email Address Years in Squires Football/Cheerleading incl. 2017
Grade 2017/18 School Year
REGISTRATION FEES: Please Make Check Payable to “NPAA” and mail with this form to the address at the bottom or you may also register online at www.northpennsquires.com. (Capped at $350 per same family)
Flag/Cheer
By May 31th : $90
By May 31th : $125
After May 31th : $110
Tackle
After May 31th : $150
Tackle Jersey: $35
Tackle Players---List Top 3 Jersey Numbers---Choice #1 Flag Player T---Shirt Size_ Cheerleader Sweatshirt Size
Choice #2
Choice #3
Equipment Agreement: Equipment care & return is the responsibility of the parent or guardian of the players. All equipment must be returned in the same condition received with the exception of normal wear. A check of $150 per cheer/football player is expected at the time of equipment handout and will be returned at the end of the season. Certain personal items i.e. football cleats, athletic supporters, game socks and cheer accessories are not included but may be required. The tackle football players will need to purchase a personalized football jersey with the last name on the back.
MANDATORY FUNDRASIER: Each family is responsible for selling 3 Football Mania tickets totaling $60, which will be collected during equipment handout. Cancellation Fee: $25 through August 30, 2015. No refunds after August 30, 2015. All equipment must be returned before any monies refunded.
Parent/ Guardian Information Father’s Name Mother’s Name Guardian’s Name (If different from Father and/or Mother)
P.O. BOX 1213 * NORTH WALES, PENNSYLVANIA 19454 * (215) 362 ---5970 WWW.NORTHPENNSQUIRES.COM
NORTH PENN ATHLETIC ASSOCIATION REGISTRATION PAGE 2
VOLUNTEER INFORMATION: The NPAA is a volunteer non---profit organization. Parent participation is mandatory. Parents are expected to participate in volunteer activities during the season--- approximately 5 hours. (your initials) Everyone will be obligated to perform some volunteer duties such as snack stand, field crew (down markers, raffle tickets, half time snack, etc.) (your initials). Listed below you will find various ways to volunteer. Please CIRCLE at least one area in which you have an interest & are committed to help. Football Coach Building & Grounds First Aid/Medical Field Maintenance
Team Parent Communications/Photo Fundraising Beef N Beer
Snack bar Sponsorship Equipment
Cheering Coach Banquet Website
My son/daughter has my permission to participate in the Football/Cheerleading program of the North Penn Athletic Association for the 2015 Season. I understand that participation in athletic competition, as well as practicing for athletic competition, involves hazards and risks of personal injury, including but not limited to fractured bones, lacerations, and damage to the nerves and nervous system, some of which may be serious and/or permanent in nature. I recognize that I have the right to inspect the condition of all equipment, playing surfaces and related facilities prior to use of the same, and to have my son or daughter refrain from participation in the event of any defects or hazards. I assume all risk and hazards to such participation including transportation to and from activities. I hereby waive, release, absolve, indemnify, and agree to hold harmless the officers, managers, directors, and coaches of the North Penn Athletic Association from any claim arising out of an injury to my son/ daughter.
I further understand that the North Penn Athletic Association will not provide accident insurance of any kind and I am solely responsible for any medical and surgical bills which result out of an injury which may arise from my son’s/daughter’s participation in any of the programs of the North Penn Athletic Association. I am solely responsible for equipment assigned to my son/daughter and will return said equipment at the completion of the season or as requested by the association. If I fail to return all equipment issued, I understand that I must reimburse the North Penn Athletic Association $150 per football and cheerleading uniform. I understand that my child will not be able to participate until financial commitments have been met. I understand failure to sign this form will result on the disqualification of my child from further participation in the 2015 football season and I will not be entitled to any refund of registration, uniform, and/or fundraising fees. I understand that I am responsible for my child’s behavior while my child is at practice, games, and any other NPAA sponsored activities.
Parent Name Parent Signature
Date
ACCIDENT INSURANCE INFORMATION Insurance Company I.D. #_
GROUP #_
REGISTRATION AND/OR UNIFORM FEE
☐
PAID BY CHECK
CHECK #_______________
❑
PAID BY CASH
☐
AMOUNT PAID__________________ DATE_____________
PAID BY CREDIT CARD
“BETTER SPORTSMEN TODAY, BETTER CITIZENS TOMORROW”
P.O. BOX 1213 * NORTH WALES, PENNSYLVANIA 19454 * (215) 362 ---5970 WWW.NORTHPENNSQUIRES.COM
