Harlem Jets Flag Football Signup
Thank you for your interest in participating in our Flag Football Clinic! Please complete the form below to register.
Name
First Name
Last Name
E-mail
example@example.com
Phone Number
-
Area Code
Phone Number
Age
Gender
Male
Female
T-shirt Size
Guardian/Parent Name
First Name
Last Name
Relationship to the Participant
Phone Number
Emergency Contact - Name (If different from Parent/Guardian)
Phone
Medical Information: Does the participant have any allergies, medical conditions, or special needs? (Yes/No) ______________
Please Select
Yes
No
If yes, please specify:
Is the participant currently taking any medications? (Yes/No)
Please Select
Yes
No
Liability Waiver and Photo ReleaseI, the undersigned, hereby release and hold harmless the organizers, coaches, volunteers, and facility owners from any and all liability related to participation in the Flag Football Clinic. I also grant permission for photographs or videos of my child to be used for promotional purposes.
Yes
No
Please Sign and Date
Continue
Continue
Should be Empty: