JVAAF.com

Prices:

Football $175.00 for registration and $100.00 fundraiser total $275.00

Cheer $150.00 for registration and $100.00 for fund raiser total $250.00

Cheer mascott registration $100.00 and $100.00 for fund raisers total $200.00

Future league registration $100.00 and fund raiser $100.00 total $200.00

Registration Date

Date of Birth

Season Year

Age on 7/31

Weight

How did you hear about us?

Child's name must be as it appears on the birth certificate:

Child's Full Legal Name:

Last
First
Middle

Address

City

Zip

School

Address

City

Zip

Insurance Carrier

Phone

Policy #

Allergies, please list or indicate none with N/A:

Physical or other limitations, list or indicate none with N/A:

Other family members participating? Names:

Responsible Parent or Legal Guardian:

Name:

Last: First:

Relationship:

Address

City

Zip

Home #

Cell#

Work #

E-mail:

Additional Contacts:

Name:

Last: First:

Relationship:

Address

City

Zip

Home #

Cell #

Work #

E-mail:

Mandatory Parent I Guardian Participation - There will be a $25 fee, per participant, for non-participation:

Football/Cheer Coach

Chain Crew

Game Assistance

Asst Football/Cheer Coach

Time Keeper

Video Camera/Photography

Team Parent

Field Set-up/Clean-up

Weigh-In Official (attend Clinic)

Board Member

Must Play Monitor

Non-participation

Name on Credit Card

Type of Card (Visa, Mastercard, Etc)

Credit Card Number

Expiration Date

Three Digit Number on Back of Card

Associated Address

City

State

Zip