ST. PETER’S FOOTBALL REGISTRATION

4th - 7th grade boys football registration form
Geoff Wilson, Football Coordinator.

Parents of children planning to play Parochial League Basketball for the upcoming season must register the child by 1) completing the St. Peter's registration form below, 2) completing the Parochial League registration form on PART B and PART C, 3 ) paying the registration fee per student of $90, made payable to St. Peter's Athletic Program.

GENERAL INFORMATION
Participant's Name:
Grade Level:
Date of Birth:
Parent's/Guardian Name(s):
Address:
City:
State:
Zip:
Daytime Phone:
Evening Phone:
Parent's E-mail:
Student's E-mail:
Height:
  
Weight:
  
Hat Size:
   

I would be interested in helping to coach: Yes Maybe Name:

   
STUDENT MEDICAL INFORMATION

In case of an emergency call:
Relationship:
Phone No.
Physician:
Phone No.
   
Hospital Preference:
Insurance:
Policy No.
   

Emergency authorization: The undersigned parent of the named participant hereby authorizes the coaches, assistant
coaches, parents of team members acting at activity supervisors or vehicle drivers as agents for the undersigned to
consent to emergency treatment of our minor child, the named participant, as indicated below:

Check if you agree:

In case of emergency, we authorize treatment at any hospital.
Signature of Parent/Guardian _______________________________________________________________
Date _______________________

FEE WAIVER
The fee for football is $90. Any forms received without payment attached will be returned as incomplete.
 Please indicate below if you wish to request a fee waiver due to financial hardship. This information will remain
condidential.
We wish to have the fee waived.
Signature of Parent/Guardian ____________________________________________________
       
  
       

PLEASE NOTE: You must print this page out before continuing on to print out PART B and PART C

 
 
YOU MUST COMPLETE PART B AND C OF THE REGISTRATION FORM!
bottom Home • Volunteer Signup • Volunteer Schedule • Registration • Calendar • Policies • SPAC • Links