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2024 Player Registration
*
JFL 2024 Teams:
Pearl Chargers
PG Titans
Hinds Co Saints
Crystal Springs Tigers
*
Sport:
Tackle Football
Cheer
PLAYER INFORMATION
*
First Name:
*
Last Name:
*
Birthdate:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
*
Gender:
M
F
*
Grade:
K
1
2
3
4
5
6
7
8
9
10
11
12
PARENT/GUARDIAN #1
*
Firstname:
*
Lastname:
*
Home Phone:
Email:
*
Parent, Guardian or Adult E-mail:
MEDICAL/EMERGENCY CONTACT INFORMATION
CONSENT FOR MEDICAL TREATMENT (MINOR) as the parent or legal guardian of the above-named player, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb or well-being of my dependent.
*
Medical Issues:
Yes
No
*
Emergency Contact:
*
Phone:
Relation to Player:
father
mother
grandfather
grandmother
guardian
WAIVER INFORMATION
I/we agree with the above
*
*
Parent Signature:
* indicates required fields