Warren County Youth Football League Player Registration And Equipment Form
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1
2WARREN COUNTY YOUTH FOOTBALL LEAGUE PLAYER REGISTRATION AND EQUIPMENT FORM
The WCYFL Board urges you to thank and
support our League Sponsor:
LAWLESS ORTHODONTICS
.
Thank you Dr. Lawless!!
PLAYER INFORMATION
Current
Age:
Name:
(First)
(Middle or initial)
(Last)
Birth
Address:
Date:
(MM)
(DD)
(YYYY)
City:
State:
Zip:
Elementary School District
Team played on last :
player RESIDES in:
Elementary School District
Division Played in last :
player ATTENDS :
PARENT / GUARDIAN INFORMATION
Parent
E-Mail:
Name:
Home
Cell
Work / other phone:
Phone:
Phone:
Parent
E-Mail:
Name:
Home
Cell
Work / other phone:
Phone:
Phone:
Alternate contact
Work / other phone:
Additional
information,
comments; email
addresses,etc.
MEDICAL INFORMATION
Insurance
Policy
Company:
Number:
Medications:
Allergies:
Additional
Comments:
This Section for WCYFL Use Only
Verification of
1)
2)
WCYFL registration number:
Residence:
Other age
League
Birth Certificate:
verification:
age:
(As of August 1st)
Helmet Striped?
Weight:
Division assigned:
EQUIPMENT
SIZE
COMMENTS
Game Jersey
Integrated pants
Pants
Additional Info /
Comments:
PAYMENT INFORMATION
PAID STAMP
Credit
Receipt
Received by:
Check #:
Cash:
card :
#:
Last revised: 7-06-16
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