Registration Form Pre-Registration Opens June 1, 2025 Pre-Registration Cost is $150.00 You Will be registering for 2025-26 Season Rules Read Agreements Registration Agreement Player Code of Conduct Concussion Acknowledgement Parent Agreement Parent Code of Conduct Speed & Agility Training 1Player/Parent Info2Insurance Info3Agreements & Consent4Payment and Confirmation Registration Date MM slash DD slash YYYY Player/Parent InfoPlayer's Name(Required)Date of Birth(Required) MM slash DD slash YYYY Age(Required) 2025-26 SCHOOL YEAR (kids ENTERING 3rd/4th/5th/6th)Grade 2024/2025(Required)Current School(Required)REQUIRED: Please attach a copy of player's birth certificate here(Required)Accepted file types: jpg, png, pdf, docx, doc, heic, gif, Max. file size: 256 MB.Shirt Size(Required)Youth MediumYouth LargeAdult SmallAdult MediumAdult LargeAdult XLLast Year's TeamDo you wish to rejoin?(Required) Yes No Parent #1 Name(Required)Parent #1 Phone(Required)Parent #2 NameParent #2 PhonePrimary Contact Email(Required) Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Emergency Contact Name(Required)Emergency Contact Phone(Required) Insurance InfoThe League does not carry insurance for your child. Please provide proof of your insurance.Insurance Provider(Required)Policy Holder(Required)Policy Number(Required)Contact Info(Required)Primary Physician(Required)Physician Phone(Required)Preferred Hospital(Required) Registration AgreementRead Registration Agreement HereRegistration Agreement(Required) I agree to the terms of the Registration Agreement Parent/Guardian Signature(Required)Filling out this field acts as a binding signature.Date(Required) MM slash DD slash YYYY Parent AgreementRead Parent Agreement HereParent Agreement(Required) I agree to the terms of the Parent Agreement Parent/Guardian Signature(Required)Filling out this field acts as a binding signature.Date(Required) MM slash DD slash YYYY Parent Code of ConductRead Parent Code of Conduct HereParent Code of Conduct(Required) I agree to the terms of the Parent Code of Conduct Parent/Guardian Signature(Required)Filling out this field acts as a binding signature.Date(Required) MM slash DD slash YYYY Player Code of ConductRead Player Code of Conduct HerePlayer Code of Conduct(Required) I agree to the terms of the Player Code of Conduct Player Signature(Required)Filling out this field acts as a binding signature.Date(Required) MM slash DD slash YYYY Concussion AcknowledgmentRead Concussion Acknowledgement HereConcussion Acknowledgement(Required) I have read and understand the Concussion Acknowledgement Parent/Guardian Signature(Required)Filling out this field acts as a binding signature.Date(Required) MM slash DD slash YYYY Player Signature(Required)Filling out this field acts as a binding signature.Date(Required) MM slash DD slash YYYY Payment & ConfirmationScholarship Code (if applicable) Football Pre-Registration Cost Price: Football Pre-Registration Cost Price: Football Pre-Registration Cost Price: Football Pre-Registration Cost Price: Football Pre-Registration Cost Price: Total $0.00 Credit Card(Required)Card Details Cardholder Name Δ
