west covina junior all american 2018 football
Deposit $ ______________ Date: _____________ Receipt # ________________
WEST COVINA JUNIOR ALL AMERICAN 2018 FOOTBALL & CHEERLEADER APPLICATION Registration Fees: Cheer $260.00 / Flag $270.00 / Tackle $290.00 ($50.00 Prepaid Raffle Fundraiser and $50.00 Snack Bar Fee is included with the Registration Fee) Deposit Amount minimum $50.00 at the time of registration.
PARTICIPANT 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
LBS
of the current year.*
Full Name (as seen on birth certificate) : Gender(Please circle):
Date of Birth (MM/DD/YYYY) :
Male
Female
League Age:
City:
Address: School Attending as of New School Year:
ZIP Code: G.P.A. at the time of Registration:
PREVIOUS FOOTBALL OR CHEER EEXPERIENCE Is PARTICIPANT a returning W.C. Player or Cheerleader (Please circle):
Yes
No
Number of years played or Cheered:
Did the PARTICIPANT play for another SGVJAAFC City last season if so which city:
PARENT/GUARDIAN INFORMATION Parent/ Guardian Name: Cell Phone:
Relationship: Email:
If you are a W.C. Bruin staff member indicate division and position(s): Check all that apply: Football Cheer Board Member
Division:
Parent/ Guardian Name: Cell Phone:
Position: Relationship:
Email:
If you are a W.C. Bruin staff member indicate division and position(s): Check all that apply: Football Cheer Board Member
Division:
Position:
EMERGENCY CONTACTS Name:
Phone:
Relationship:
Name:
Phone:
Relationship:
I understand that a full refund will only be given to a participant who drops before the first day of practice. Refer to “Refund Policy” 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: o All Players/Cheerleaders: Final Report Card for the 2018 School Year o New Players/Cheerleaders: Original Birth Certificate and Proof of Address. I understand that my son/daughter will not be able to participate or WILL NOT be issued any equipment if all fees are NOT PAID by July 23, 2018.
I/WE AGREE WITH THE TERMS LISTED ABOVE* Parent/ Guardian Signature:
Date:
Parent/ Guardian Signature:
Date:
WEST COVINA JUNIOR ALL AMERICAN 2018 FOOTBALL & CHEERLEADER APPLICATION Registration Fees: Cheer $260.00 / Flag $270.00 / Tackle $290.00 ($50.00 Prepaid Raffle Fundraiser and $50.00 Snack Bar Fee is included with the Registration Fee) Deposit Amount minimum $50.00 at the time of registration.
PARTICIPANT 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
LBS
of the current year.*
Full Name (as seen on birth certificate) : Gender(Please circle):
Date of Birth (MM/DD/YYYY) :
Male
Female
League Age:
City:
Address: School Attending as of New School Year:
ZIP Code: G.P.A. at the time of Registration:
PREVIOUS FOOTBALL OR CHEER EEXPERIENCE Is PARTICIPANT a returning W.C. Player or Cheerleader (Please circle):
Yes
No
Number of years played or Cheered:
Did the PARTICIPANT play for another SGVJAAFC City last season if so which city:
PARENT/GUARDIAN INFORMATION Parent/ Guardian Name: Cell Phone:
Relationship: Email:
If you are a W.C. Bruin staff member indicate division and position(s): Check all that apply: Football Cheer Board Member
Division:
Parent/ Guardian Name: Cell Phone:
Position: Relationship:
Email:
If you are a W.C. Bruin staff member indicate division and position(s): Check all that apply: Football Cheer Board Member
Division:
Position:
EMERGENCY CONTACTS Name:
Phone:
Relationship:
Name:
Phone:
Relationship:
I understand that a full refund will only be given to a participant who drops before the first day of practice. Refer to “Refund Policy” 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: o All Players/Cheerleaders: Final Report Card for the 2018 School Year o New Players/Cheerleaders: Original Birth Certificate and Proof of Address. I understand that my son/daughter will not be able to participate or WILL NOT be issued any equipment if all fees are NOT PAID by July 23, 2018.
I/WE AGREE WITH THE TERMS LISTED ABOVE* Parent/ Guardian Signature:
Date:
Parent/ Guardian Signature:
Date:
