2018-19

GODDARD JUNIOR HIGH FOOTBALL

REGISTRATION FORM

 

STUDENT FIRST NAME: _____________________________________________________

 

STUDENT LAST NAME: ______________________________________________________

 

GRADE: ______AGE: __________DATE OF BIRTH: ________________________________

 

ADDRESS: ____________________________________________________________________

 

CITY: __________________________________________________STATE: _____ZIP: _______

FATHER NAME: ________________________CELL #_______________________________

 

FATHER EMAIL ADDRESS: _________________________________________________________

MOTHER NAME: ________________________CELL #_______________________________

 

MOTHER EMAIL ADDRESS: _________________________________________________________

 

STATIONS:

1)MEDICAL____________INHALER_______________EPI PEN_______________OTHER________________

 

2)GREY PRACTICE SHORTS #__________GREY PRACTICE SHIRT#_____________

 

3)HELMET SIZE___________MOUTH PIECE_______________

 

4)SHOULDER PADS____________________PRACTICE JERSEY#______________

 

5)PANTS SIZE____________

 

6) LOCKER #_______LOCKER COMBINATION #_____________________LAUNDRY CLIP #_________

 

PARENT/GUARDIAN PERMIT TO PLAY WAIVER:

If in the judgment of any representative of the school, this student should need immediate care and treatment as a result of an injury or sickness, I do hereby request, authorize and consent to such care and treatment as may be given to this student by any physician, athletic trainer, nurse or school representative, and I do hereby agree to indemnify and save harmless the school and any school representative from any claim by any person whomever on account of such care and treatment of said student.

 

 

 

Signature of Parent/Guardian                                               Date: