New Melle Sports & Recreation

                                        Football and Cheerleader

Player Registration Form

Football ______

Cheerleader_______

Parent/Guardian _________________________________ Phone No. __________________

Address  _______________________________________ Zip Code ___________________

Occupations _________________________ School / School District __________________ 

Email _______________________________                          

Name                                                                                      Birthdate _________  Age _____                        M / F

            Helmet                                   Shoulder Pad                                   Pants                         

Name                                                                                      Birthdate _________  Age _____                        M / F    

            Helmet                                   Shoulder Pad                                   Pants                         

Name                                                                                      Birthdate _________  Age _____                        M / F    

            Helmet                                   Shoulder Pad                                   Pants                         

Name                                                                                      Birthdate _________  Age _____                        M / F    

            Helmet                                   Shoulder Pad                                   Pants                         

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Fees: Make Checks Payable to: (NMSR) New Melle Sports & Recreation

            Football                                                                                  Cheerleader

            First child                   $140                                                   First child       $100

            Two children              $250                                                   Two or more  $80 per additional child

            3 or more                   $100 per additional child

            Equipment Deposit $100 per child

Approved by __________________________________ Date ____________

Amount Paid ____________ Check No. ____________ Cash ____________

Bring the Following

Copy of Birth Certificate

Current Small Photo