Summer 2025 Rosenberg Panthers Co-Ed Flag Football Registration

Summer 2025 Rosenberg Panthers Co-Ed Flag Football Registration

Fill out the form carefully for registration
Participant's Name*

First NameMiddle NameLast Name
Age (As of 1/1/25)*
Age Division Request*
Birth Date*

MonthDayYear
Jersey Number 1*
Jersey Number 2*
Jersey Number 3*
Top Size*
Bottom Size*
Preferred Position *
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent's Name*
E-mail*
example@example.com
Mobile Number*
Participant's Allergies*
Participant's Medical Conditions*

Bylaws/Code of Conduct Agreement*

I agree to the rules and regulations that govern your organization.
WAIVER OF LIABILITY RELEASE FORM
I am aware of the nature of this sport and I hereby assume responsibility for blanks* (Participant Name) to participate and to be photographed for publicity purposes. I will not hold the ROSENBERG PANTHERS and/or its coaches responsible in the case of accident or injury as a result of this participation. I understand that this completed form must be in the possession of the PANTHERS YOUTH BASKETBALL ASSOCIATION prior to participation in this program.
Signature*

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Date*

MonthDayYear
Date

Payment Options*

Co-Ed Flag Football Registration

$90.00 Quantity

Pay Offline

$ Free Quantity

Enter coupon

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Credit Card

Cash App Pay

Afterpay

WAIVER OF LIABILITY RELEASE FORM