Upward football and Cheerleading Registration

First Name

 

Last Name

 

Sport  Football   Cheerleading

 

Address 

 

City    Zip

 

Home phone      Cell 

 

Age   

 

Birthdate    

 

Gender  Male   Female  

 

Grade

 

Days you can't practice  Monday  Tuesday Wednesday Thursday

 

Mother's Name

 

Mother's Phone Number 

 

Father's Name

 

Father's Phone Number

 

What church do you attend? 

 

Parent's Email Address 

 

  I would be willing to coach

 

  Registration Fee:  $70 Prior to August 22;  $80 After August 22.   Payment must be received before registration is complete.