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Register Here for the 2013 Spring Flag Football Season!

*Player's First Name: *Player's Last Name:
*Address:
*City:
*State:    *Zip Code:
   
Height: (ex: 5ft 6in) Weight:

*Birth Date (yyyy-mm-dd):

   
*Current School:
*Current Grade Level (as of July 31, 2012):
*Has had a physical within the last 12 months.
Referred by someone?
Referral Name:
*Has child participated in any other football program?
If "yes" Please list the name of the organization:
     
PARENT/GUARDIAN EMERGENCY CONTACTS
(Contact must be 21 years of age .)
 
*Parent/Guardian(1) First Name:
*Parent/Guardian(1) Last Name:
*Email address:
*Home Phone: *Cell Phone: Work Phone:
 
 
Parent/Guardian(2) First Name:
Parent/Guardian(2) Last Name:
Email address:
Home Phone: Cell Phone: Work Phone:
Any Special Requirements or Notes:  

 

*I grant permission to my child or ward to participate in football and assume all risks and hazards incidental to football participation, including transportation to and from activities. I also agree to perform volunteer duties as requested by UNITY coaches and administrators. I grant permission to UNITY officials to consent to emergency treatment for my child until a legal guardian can be contacted. I agree to pay the cost of any lost equipment and/or uniform issued to my child or me by UNITY.

Before the player is eligible to participate, payment in full must be received. The fee for Spring Flag Football per player is $50.00. Payment options are 1.) Pay online using a credit card via our Google Merchant Account, 2.) Send a check or money order to UNITY, or 3.) Provide payment the first day of practice with an additional $5.00 per player for process handling. Please indicate below how you would like to handle payment.

Voucher Number