2023 Trench Mob Team Registration Form

2023 Trench Mob 5v5 Big Man

Registration Form
PLAYER INFORMATION
Full Name:*

First NameLast Name
Birth Date:*

MonthDayYear
Grade entering in 2022/2023 school year:
Gender:*
Uniform Size:*
Identifications Cards

A copy of all ID cards will need to be submitted ASAP so there is no delay in getting this season off the ground. If there is any additional questions please email trenchmobinfo@gmail.com.
Please upload a CLEAR, valid copy of the player's ID or birth certificate

Browse Files

Cancelof

Parent / Guardian

If parents or Guardians are in separate household please list them under Emergency Contact.
Full Name:*

First NameLast Name
Relationship to Child:*
Address: Where the child(dren) stay at primarily *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone:*

Area CodePhone Number
Email*
example@example.com
Can you accept text messages?
EMERGENCY CONTACT INFORMATION
Full Name:*

First NameLast Name
Relationship to Child:*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Phone: '*

Area CodePhone Number

WAIVER INFORMATION
I hereby grant permission to allow my child to participate in activities (i.e. practice, tournaments, etc) as sponsored by Battle of the Trenches Foundation - Trench Mob Big Man Team.

Furthermore, I hereby release the Battle of the Trenches organization, it’s officers, agents, and coaches from any legal or financial responsibility resulting from actions of, or injury to my child while engaged in any or all of these sponsored activities (i.e. practices, games, competitions). It is my understanding that every registered participant will be covered by their own personal insurance.

I also certify that my child has NO HEALTH OR PHYSICAL IMPAIRMENTS which will hamper his/her ability to perform as a player/cheerleader or cause his/her participation to be unsafe to themselves or other participants. If there are any health/physical problems the Battle of the Trenches should be aware of please indicate below:
Health/Physical Limitations with medication if any (if NONE just write N/A):*
I authorize the Battle of the Trenches to use my child(dren) image and/or likeness in official media, including: Our website, promo material, newsletters and related media.*

YesNo

Payment

All payments are non-refundable. Registration fee of $500 is due by December 2, 2022. To complete registration, submit your payment. To make payment arrangements, please email trenchmobinfo@gmail.com. Failure to pay by due date could result in your player being removed from the team.

My Products

Full Registration$500.00

Registration Deposit (No Refunds)$250.00

Remainder due by December 2, 2022. Must confirm payment plan with Administrator.

UCF 5v5 Camp Fee Only$125.00

Quantity

UCF 5v5 Camp$300.00

March 25 14u Camp $25.00

Enter coupon

Total $0.00

2023 Trench Mob 5v5 Big Man