Cougars KREW 2020 Registration

Players Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Players Birth Date*

MonthDayYear

Please Provide

Parent/Guardian 1*

First NameLast Name

Phone Number 1*

Area CodePhone Number

E-mail 1*

Parent/Guardian 2

First NameLast Name

Phone Number 2

Area CodePhone Number

E-mail 2

Emergency Contact

First NameLast Name

Emergency Phone #

Area CodePhone Number

Senior Tackle $470.00, *Returnee TBA **Ages 11-13; Min 65 - 145 lbs
Junior Tackle $470.00, *Returnee TBA **Ages 9 - 11; Min 55 - 125 lbs

*Returnee $$$ TBA "To Be Announced" with equipment: Matte Black helmet and pads (Adjusted price will be announced at Orientation)

**MID SEASON WEIGH IN – Junior Tackle Max 130lbs and Senior Tackle Max 150lbs

**TACKLE PLAYERS UNDER THE MIN WEIGHT, MUST SIGN A WAIVER.

**TACKLE PLAYERS UNDER 9 YEARS OF AGE, MUST SIGN A WAIVER.

Sophomore Flag (email for availability) *Ages 8, 9 & 10 - No Weight Limit
Freshman Flag (email for availability) *Ages 5, 6 & 7 - No Weight Limit

$100 Deposit paid to hold roster position. Balance due at Parents Meeting.

Select Division*

Senior TackleJunior TackleSophomore FlagFreshman Flag

Deposit Paid by:

CHECK $100

PayPal Junior Tackle$100.00

Total $0.00

I/We the parent/guardian of {name} hereby give my permission to participate in all football/cheer activities during the current football season. I/We, assume all risks and hazards incidental to such participation including transportation to and from the activities. I/We hereby waive, release, absolve, indemnify and hold harmless the Cougar's KREW and any person(s) transporting my/our child to and from activities from any claim(s) arising out of injury to my/our child, whether the injury is a result of negligence or for any other cause except to the extent and in the amount covered by the accident of liability insurance. In the event of an injury to my/our child, I/We hereby grant authorization to a qualified physician to render such medical treatment as deemed necessary. IMAGE RELEASE: I agree to authorize that photographs or video/digital images of said minor may be published in an outlet (website/news media) used to promote or publicize the Cougar's KREW and its sport programs. I FULLY ACKNOWLEDGE/UNDERSTAND THAT A DEPOSIT IS DUE AT TIME OF REGISTRATION TO HOLD MY CHILD/PLAYER SPOT ON THE ROSTER. ALL FEES ARE NON-REFUNDABLE AFTER SEPTEMBER 1, 2019.

Initials*

Registration Instructions:
*Fees must be paid at time of registration.
*Copy of birth certificate must be turned in by first official practice August 1.
*Copy of proof of medical insurance (card) must be turned in with birth certificate or upload from your computer in SELECT IMAGE below.
*Physical must be completed before a player can practice.
*Birthdates after July 1st may receive an extra year of eligibility
**PAYPAL AND CHECKS ACCEPTED ONLY **NO CASH** Make Checks Payable to Cougars KREW Glenn Iwasaki, P.O. Box 240760 Honolulu, HI 96824

Copy of Proof of medical insurance (card). JPEG, JPG, GIF, TIF or PNG

2020 Fall Season Registration Form