Registration Form

1
Sport* This field is required.
CheerFootball
2
Team* This field is required.
Mascot (Cheer Only)
U06
U08
U10
U12
U14
3
Name* This field is required.
First Name
Last Name
4
Gender* This field is required.For Grant Purposes Only
MaleFemale
5
Ethnicity* This field is required.For Grant Purposes Only
Hispanic Or LatinoNot Hispanic Or Latino
6
Race / National Origin* This field is required.For Grant Purposes Only
American Indian Or Alaska Native
Asian
Black Or African American
Native Hawaiian Or Other Pacific Islander
White
Other
7
Date Of Birth* This field is required.
Month
Day
Year
8
Address* This field is required.
Street Address
Street Address Line 2
City
Please Select
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
9
School / Grade* This field is required.For 2023-2024 School Year
10
Allergies / Medical Conditions* This field is required.
Huge
Large
Normal
Small
Ok
Ok
11
Epi Pen Or Inhaler* This field is required.
YESNO
12
Participate Last Season* This field is required.
YesNo
13
Which Park
A & G
Bellview
Brent
Cantonment
Ensley
Gulf Breeze
Milton
Navarre
NEP
Pace
Perdido
Seahawks
SYSA
Other
14
Primary Parent / Guardian Name* This field is required.
First Name
Last Name
15
Primary Parent / Guardian Email* This field is required.
example@example.com
16
Primary Parent / Guardian Cell Number* This field is required.
###-###-####
17
Primary Parent / Guardian Receive Texts* This field is required.
YesNo
18
Secondary Parent / Guardian Name
First Name
Last Name
19
Secondary Parent / Guardian Email
example@example.com
20
Secondary Parent / Guardian Cell Number
###-###-####
21
Secondary Parent / Guardian Receive Texts
YesNo
22
Emergency Contact Name* This field is required.
First Name
Last Name
23
Emergency Contact Email* This field is required.
example@example.com
24
Emergency Contact Cell Number* This field is required.
###-###-####
25
Emergency Contact Receive Texts* This field is required.
YesNo
26
Code Of Conduct* This field is required.In Order To Place A Check In The Box, The Code Of Conduct MUST BE Read In Its Entirety!
27
Electronic Signature* This field is required.
Clear
28
Payment Type* This field is required.
Cash App
Credit Card
Square Invoice
Venmo
29
Payment Option
prevnext( X )
My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
Great Product Name
$20
Quantity:1
Size:Small
RemoveEdit
ORDER SUMMARY
Total costUSD
Cheer RegistrationCheer Registration
$160.00+Edit
Back
Football RegistrationFootball Registration
$190.00+Edit
Back
Non-Refundable DepositNon-Refundable Deposit
$50.00+Edit
Back
Enter Coupon
Total cost $0.00
Credit Card
First Name
Last Name
30
Invoice ID
31
Name
First Name
Last Name
Should be Empty: