NAGAF Football Registration

8%

Which activity are you signing up for?

How many Football players?

Please choose how many players you are signing up.

How many Cheerleaders are you signing up?

Cheer has a Uniform fee PER Cheerleader

Selecting No below will mean you must pay your uniform fee prior to season start.

Uniform Fee

Total: $

16%

Football Player 1 Information

First Name

Last Name

DOB

Do not type the date, please select using the calendar

Age

Age Group

This is automatically generated.

School

Your childs Current School

Grade

Select value

Did your child play football last year?

Select option.

Did they play at NAGAF?

Select value

Where did they play?

Select value

Jersey Number Choces

If your child has a jeresey number choice, enter them here separated by comma

Jersey Size

Select a jersey size.

Whom does the child live with?

Medical Information

Doctor or Pediatrician

Phone

LIST ANY ILLNESSES, ALLERGIES, MEDICAL CONDITIONS, MEDICATION OR SPECIAL NEEDS THAT YOUR CHILD HAS THAT NAGAF SHOULD BE AWARE OF:

Type None or N/A if not applicable.

Back

25%

Player 2 Information

First Name

Last Name

DOB

Do not type the date, use the calendar

Age

Age Group

This is automatically generated.

School

Your child's current school.

Grade

Select value

Did your child play football last year?

Select option.

Did they play at NAGAF?

Where did they play?

If your child did not play in the VFL select Other

Jersey Number Choces

If your child has a jeresey number choice, enter them here separated by comma

Jersey Size

Select a jersey size.

Whom does the child live with?

Select value

Medical Information

Doctor or Pediatrician

Phone

LIST ANY ILLNESSES, ALLERGIES, MEDICAL CONDITIONS, MEDICATION OR SPECIAL NEEDS THAT YOUR CHILD HAS THAT NAGAF SHOULD BE AWARE OF:

Type None or N/A if not applicable.

Back

33%

Player 3 Information

First Name

Last Name

DOB

Do not type the date, please select using the calendar

Age

Age Group

This is automatically generated.

School

Your child's current school.

Grade

Select value

Did your child play football last year?

Tackle Only.

Did they play at NAGAF?

Select value

Where did they play?

Select value

Jersey Number Choces

If your child has a jeresey number choice, enter them here separated by comma

Jersey Size

Select a jersey size.

Whom does the child live with?

Select value

Medical Information

Doctor or Pediatrician

Phone

LIST ANY ILLNESSES, ALLERGIES, MEDICAL CONDITIONS, MEDICATION OR SPECIAL NEEDS THAT YOUR CHILD HAS THAT NAGAF SHOULD BE AWARE OF:

Type None or N/A if not applicable.

Back

41%

Cheerleader Information

First Name

Last Name

Year Born

Select Year Born

Month Born

Select Month Born

Day

DOB

Do not type the date, please select using the calendar

Age

School

Grade

Select value

Whom does the child live with?

Medical Information

Doctor or Pediatrician

Phone

LIST ANY ILLNESSES, ALLERGIES, MEDICAL CONDITIONS, MEDICATION OR SPECIAL NEEDS THAT YOUR CHILD HAS THAT NAGAF SHOULD BE AWARE OF:

Type None or N/A if not applicable.

Back

50%

Cheerleader Information

First Name

Last Name

Year Born

Select Year Born

Month Born

Select Month Born

Day

DOB

Do not type the date, please select using the calendar

Age

School

Grade

Select value

Whom does the child live with?

Medical Information

Doctor or Pediatrician

Phone

LIST ANY ILLNESSES, ALLERGIES, MEDICAL CONDITIONS, MEDICATION OR SPECIAL NEEDS THAT YOUR CHILD HAS THAT NAGAF SHOULD BE AWARE OF:

Type None or N/A if not applicable.

Back

58%

First Name

Last Name

Year Born

Select Year Born

Month Born

Select Month Born

Day

DOB

Do not type the date, please select using the calendar

Age

School

Grade

Select value

Whom does the child live with?

Medical Information

Doctor or Pediatrician

Phone

LIST ANY ILLNESSES, ALLERGIES, MEDICAL CONDITIONS, MEDICATION OR SPECIAL NEEDS THAT YOUR CHILD HAS THAT NAGAF SHOULD BE AWARE OF:

Type None or N/A if not applicable.

Back

66%

Parent/Guardian and Emergency Contact Information

Please fill out your information. Email and a phone number are required. This information will only be used to contact you by your coach and or NAGAF.

First Name

Last Name

Your Phone Number

Parent's Email

Enter email address. This is used for communication by NAGAF

Street

Current address of child

City

State

Zip

Child's Zip Code

Please list any other emergency contacts that can be contacted if you are unavailable.

Father's Name

Father's Work Phone

Father's Preferred Number

Father's Employer

Mother's Name

Mother's Work Phone

Mother's Preferred Number

Mother's Employer

Guardian Name

Guardian Work Phone

Guardian Preferred Number

Guardian Employer

Total:

Back

Person Authorized to contact for parent in an emergency (not same household)

Name

Home Phone

Cell Phone

Address

City

State

Zip

Child May be released to this person?

Back

I agree NOT to hold the NAGAF COACHES OR BOARD MEMBERS responsible for injuries or accidents in connection with the activities and authorize the coaches/members to administer first aid which may involve sunscreen, antibiotic ointment, Tylenol, bee sting ointment (or the generic of each) in case of injury and / or secure or transport child for emergency medical treatment. (Every attempt will be made to contact parent. If any injury appears serious enough for hospitalization or medical care, such expenses will be borne by the parent or guardian.)

Please Check:

I agree with the above statement

Yes

My Child Can be released to:

Select option.

Name

Type something.

Relationship

Select value

Phone

Name

Type something.

Relationship

Select value

Phone

Back

I will be responsible for any damage or destruction that my child may incur.

Put your signature.

I agree to the above information regarding my child. I agree to the release of information to persons as listed above. I understand the any release of information to the persons other than those mentioned above will require my written approval.

Put your signature.

I GIVE / DO NOT GIVE (select one) permission to NAGAF Recreation to post pictures/information of my child on all social media.

Image Release Selection Signature

Put your signature.

Birth Certificate

Upload file.

We need to have a birth certificate on file for each player you are signing up. If you have played previously, you do not need to complete this step as we have it on file. You can upload one here or bring a copy to the first practice/meeting.

I have read and agree to the terms and conditions.

Yes

Terms and Conditions

Submit

100%

Thank you for registering at NAGAF!

You will need to fill out a Concussion Statement at the first opportunity. Signature of the student athlete and the parent/guardian is required.

Your Coach will be in touch regarding practice times and schedule. If you have any questions before hand, please email

football@nagafroadrunners.org football

OR

nagafroadrunners@yahoo.com cheer

Cheer has a Uniform fee PER Cheerleader

Your Total Will be:$

Football Player 1 Information

Medical Information

Total:

Player 2 Information

Medical Information

Total:

Player 3 Information

Medical Information

Total:

Cheerleader Information

Medical Information

Total:

Cheerleader Information

Medical Information

Total:

Medical Information

Total:

Parent/Guardian and Emergency Contact Information

Total:

Person Authorized to contact for parent in an emergency (not same household)

Thank you for registering at NAGAF!

You will be redirected for payment...

Registration is closed. For further information please contact the Director of Football via facebook: https://www.facebook.com/nagafroadrunners