SOUTH CHARLOTTE RAMS YOUTH FOOTBALL

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2019SPRING FOOTBALL REGISTRATION FORM

Participant's Information

* Player Name:

* Date of Birth:

Weight:

* Age as of 7/31/18:

* Grade Level:

* School:

Previous Team You've Played For:

* Parent or Guardian:

* Home Address:

* Home Telephone:

* Cell Phone:

Work Phone:

* Email Address:

Preferred Method of Contact:

Medical Information

Primary Care Physician:

Medical Insurance Provider:

Policy/Group #:

In the field listed below describe any allergies or health concerns we should be aware of. You can also use this space to list any additional information or concerns associated with your family.

Disclosure

I, the parent or Legal Guardian of the above named child, hereby authorizes participation in the 2018 Spring Football season with the South Charlotte Rams.

I understand that football is a contact sport and injury may occur. I release South Charlotte Rams/Steele Creek Youth Athletics from any liability for injuries associated with the sport.

I certify that the participant is physically able to participate and understand that medical insurance is my own responsibility.

By Submitting payment I am stating the following:

1. You are making a commitment to the South Charlotte Rams for the 2018 Spring Football Season and no refunds will be given

2. You live in an area that will allow you to attend practices & Games for the duration of the season

3. Your child is physically able to play Contact Youth Football and/or You have Consulted with your Primary Care Provider if there are any New or pre-existing conditions clearing him to play.

* Electronic Signiture:

* indicates required fields

IMPORTANT: Online Payment with credit cards is not active for this form

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2019SPRING FOOTBALL REGISTRATION FORM