CHESMONT CATHOLIC LIONS FOOTBALL
CATHOLIC YOUTH ORGANIZATION 2009 FOOTBALL REGISTRATION FORM
Child’s
Name: _________________________ Grade (in Fall 2009): _________
(Please
Print)
Address:
_______________________________________________________________
_______________________________________________________________
Parent’s
Names: ____________________________________________________
(Please Print)
Home Phone:
____________________ Cell Phone: _________________________
School: _________________________ Parish: ____________________________
E-mail Address: ________________________________ (Parent’s E-Mail)
MY CHILD IS REGISTERING FOR THE FOLLOWING SPORT (Please Circle Choice):
Boys Tackle
Football (Grades 5-8)
Boys Flag Football (Grades 3-4)
Parent’s Release:
In
consideration of my child noted above in this application being allowed to participate in competitive sports, I do hereby
release and forever discharge the Archdiocese of Philadelphia, St. Mary’s, St. Gabriel’s, Sacred Heart, St. Eleanor’s,
Blessed Teresa and/or members of the Catholic Youth Organization, and/or the coaching staff of Chesmont Catholic Lions from
any and all actions or suits of law or equity which I might hereafter have by reason of injuries sustained by my child while
participating in sports, or in transit to or from participation in sports.
____________________________________ _____________________________
Signature
of Parent
Date
NOTE: As a member of the Chesmont Catholic Lions Football Program you may NOT play for another organized
football team. ALL PLAYERS MUST
BE A REGISTERED MEMBER OF THEIR PARISH.
Fees: Registration for Tackle
= $150.00 for 1st Child; $100.00 for 2nd Child; 3rd child (or more), the registration fee
will remain at the 2nd child rate of $250. Registration for Flag =
$85.00 per
Child. A late fee charge of $25.00 per player will be applied for all registration forms
not submitted by Friday, 6/12/09.
Payment by: Check (No. &
Total) _________________________
Make Checks Payable (and mail) to: Chesmont
Catholic Lions Football
c/o Christine Tadros, 14 Jasper Lane, Phoenixville,
PA 19460
Parents are asked to volunteer in some way to help your child’s
team. Check all areas where you can help out:
Team Coach _______ Team Parent _______ Chain Gang _____ Snack Bar _______
Fundraising _____ Team Service Project _____ Other _____
T-Shirt Size: YS ____ YM ____ YL ____ AS ____ AM ____ AL
____ AXL ____ A2XL ____
If you have any questions, please contact either Chris Bildstein
(610/327-3893; bildstein7@comcast.net) or Dina Makoid (610/970-1588; dina.makoid@comcast.net).
