west covina junior all american 2017 football
Receipt # _____________ Deposit $ ______________ Date: _____________ Receipt # __________________ Bal Paid $______________ Date: ____________
WEST COVINA JUNIOR ALL AMERICAN 2017 FOOTBALL & CHEERLEADER APPLICATION
Registration Fees: Tackle $270.00 / Flag $220.00 / Cheer $200.00 (A Mandatory $30.00 Snack Bar Fee is included with the Registration Fee) Deposit Amount minimum 50% at the time of registration.
CANDIDATE Football or Cheer Division (Please check one): Returning FlagINFORMATION Players Only Please Indicate Last Season’s Team:
Sign Up Weight
Cheer Jr. Gremlin(flag)- Blue Gold White Black Gremlin Jr Pee Wee Pee Wee Jr Midget Midget *Please Note: League Age is determined as of July 31st of the current year.*
Full Name (as seen on birth certificate) : Date of Birth (MM/DD/YYYY) :
Gender(Please circle): Male
Address:
City:
Female
League Age: ZIP Code:
School Attending as of New School Year:
G.P.A. at the time of Registration:
PREVIOUS FOOTBALL OR CHEER EEXPERIENCE Is Candidate a returning W.C. Player or Cheerleader (Please circle): Yes
No
Number of years played or Cheered:
Did the Candidate play for another SGVJAAFC City last season if so which city:
PARENT/GUARDIAN INFORMATION Parent/ Guardian Name:
Relationship:
If you are a W.C. Bruin staff member indicate division and position(s): Check all that apply: Football
Cheer
Board Member
Division:
Position:
Address (if different than candidate’s): Home Phone:
Cell Phone:
Email:
Parent/ Guardian Name:
Relationship:
If you are a W.C. Bruin staff member indicate division and position(s): Check all that apply: Football
Cheer
Board Member
Division:
Position:
Address (if different than candidate’s): Home Phone:
Cell Phone:
Email:
EMERGENCY CONTACTS Name:
Phone:
Relationship:
Name:
Phone:
Relationship:
SIGNATURE Parent/ Guardian Signature:
Date:
Parent/ Guardian Signature:
Date:
Initials:
_________________
Initials:
_________________
Initials:
_________________
Initials:
_________________
Initials:
_________________
I understand that a full refund will only be given to a participant who drops before the first day of practice. I understand that no refunds will be given to any participant who does not meet the Academic requirements of a 2.0 GPA after the first practice. I have medical insurance to cover any injuries to the participant and understand that insurance from the WCJAAFC is only for secondary coverage. I understand that a participant may be removed from the program if they or their parent/guardian does not adhere to the code of conduct standards. Items needed before final registration can be completed: Original Birth Certificate & Most Current Report Card.
LBS
WEST COVINA JUNIOR ALL AMERICAN 2017 FOOTBALL & CHEERLEADER APPLICATION
Registration Fees: Tackle $270.00 / Flag $220.00 / Cheer $200.00 (A Mandatory $30.00 Snack Bar Fee is included with the Registration Fee) Deposit Amount minimum 50% at the time of registration.
CANDIDATE Football or Cheer Division (Please check one): Returning FlagINFORMATION Players Only Please Indicate Last Season’s Team:
Sign Up Weight
Cheer Jr. Gremlin(flag)- Blue Gold White Black Gremlin Jr Pee Wee Pee Wee Jr Midget Midget *Please Note: League Age is determined as of July 31st of the current year.*
Full Name (as seen on birth certificate) : Date of Birth (MM/DD/YYYY) :
Gender(Please circle): Male
Address:
City:
Female
League Age: ZIP Code:
School Attending as of New School Year:
G.P.A. at the time of Registration:
PREVIOUS FOOTBALL OR CHEER EEXPERIENCE Is Candidate a returning W.C. Player or Cheerleader (Please circle): Yes
No
Number of years played or Cheered:
Did the Candidate play for another SGVJAAFC City last season if so which city:
PARENT/GUARDIAN INFORMATION Parent/ Guardian Name:
Relationship:
If you are a W.C. Bruin staff member indicate division and position(s): Check all that apply: Football
Cheer
Board Member
Division:
Position:
Address (if different than candidate’s): Home Phone:
Cell Phone:
Email:
Parent/ Guardian Name:
Relationship:
If you are a W.C. Bruin staff member indicate division and position(s): Check all that apply: Football
Cheer
Board Member
Division:
Position:
Address (if different than candidate’s): Home Phone:
Cell Phone:
Email:
EMERGENCY CONTACTS Name:
Phone:
Relationship:
Name:
Phone:
Relationship:
SIGNATURE Parent/ Guardian Signature:
Date:
Parent/ Guardian Signature:
Date:
Initials:
_________________
Initials:
_________________
Initials:
_________________
Initials:
_________________
Initials:
_________________
I understand that a full refund will only be given to a participant who drops before the first day of practice. I understand that no refunds will be given to any participant who does not meet the Academic requirements of a 2.0 GPA after the first practice. I have medical insurance to cover any injuries to the participant and understand that insurance from the WCJAAFC is only for secondary coverage. I understand that a participant may be removed from the program if they or their parent/guardian does not adhere to the code of conduct standards. Items needed before final registration can be completed: Original Birth Certificate & Most Current Report Card.
LBS
