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    • Spring 2015 Season

Player's Information

First Child

First Name:*

Last Name:*

M.I.:

Date of Birth:*

Jersey Size:*

Sex:*

Second Child

First Name:*

Last Name:*

M.I.:

Date of Birth:*

Jersey Size:*

Sex:*


Register's Information

Home Address:*

City:* State:* Zip Code:*

Email:*

Emergency Contacts

Father's Name: Phone #: Email:

Mother's Name: Phone #: Email:

Guardian's Name: Phone #: Email:

Two Emergency Contact Names, Relationship to Child and Phone Numbers:

Medical Insurance Company:

Physician Name/Number:

Forms

Please read the forms below before submitting your registration:

General Information Form

General Information - Parents/Legal Guardian - *Please enter your initials:

Liability Forms

Please read the liability forms below to determine which form is applicable to you. Please answer both questions.

Limitation of Liability for Minor Participants - *Please enter your initials or enter NA if this form is not applicable to you:

Limitation of Liability for Participants - *Please enter your initials or enter NA if this form is not applicable to you:

Medical Release Form

Medical Release Form

Please acknowledge you have read this form*:

Other Participation

Fundraiser Commitment Letter

Will you participate in the Fundraiser?*

Do you have interest in being a Coach?

Do you have interest in being a Referee ?

Do you have interest in being a Team Parent ?

*All registration fees must be paid in full after submission. You'll be redirected to Paypal after submitting your registration.

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South Bronx Saints

501(c) (3) not-for-profit organization. Your donations are welcomed and are tax deductible under the amount permissible by law. Click to learn more about our organization or how to make a donation.

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CONTACT US

South Bronx, New York
southbronxsaints@yahoo.com
646-330-1355