2019 Central Kings Football Registration
Form must be completed before player can participate in any football practice or game.
Player Information
Player's First Name *
Your answer
Player's Last Name *
Your answer
Player's Date of Birth *
MM
/
DD
/
YYYY
Grade *
Street Address *
Your answer
City *
Your answer
Postal Code *
Your answer
Player's Cell Phone Number (If Applicable)
Your answer
Player's E-Mail Address
Your answer
T-Shirt Size (All sizes are adult) *
Have you ever played organized football before? If so please list years and position(s) played.
Your answer
Other player commitments during season? Please check all that are applicable.
Guardian Information
Guardian's Name *
Your answer
Guardian's Address (if different than above)
Your answer
Guardian Phone Number *
Your answer
Guardian's E-Mail *
Your answer
I will support the program by volunteering for the following *
Required
Medical Information
Health Card Number *
Your answer
Health Card Expiry Date *
Your answer
Family Doctor *
Your answer
Has the player been diagnosed with a concussion? If so, please list severity and date. *
Your answer
Has the player been diagnosed with any allergies? *
Your answer
Has the player been diagnosed with any conditions that would affect playing a contact sport? *
Your answer
Any other medical concerns that the coaches should be aware of?
Your answer
Additional Information
Guardian Consent
I understand that the fees for the 2019 season will be $275 with the expectation of full team participation to cover increased travel fees. (Registration fees due by cash, cheque or payment arrangement by September 30, 2019). *
Required
I understand that gear will NOT be issued until registration is complete, payment arrangements made and volunteer commitments established *
Required
I understand that the Football season is a short season and that every effort needs to be made to attend all practices. *
Required
I understand that Central Kings Football playing time is not equal time. Further information will be discussed at September parent meeting. *
Required
I give permission for the CK Football Team to use my athlete's picture on our Facebook Page and Website *
Required
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