College Church of the Nazarene
Online Registration for Upward Flag Football and Cheerleading
 

Participant Information
Payment is $80 due on Evaluation Night (payable to College Church)
   
  First Name * MI Last Name *
     
  Address
  City
  State
  Zip
     
  Email
     
  Church
     
  School
       
  Date of Birth * (MM/DD/YY)
       
  Phone number (XXX) XXX-XXXX
       
  Years of Upward experience * Gender * Grade *
             
 
Sizing Information
   
  Jersey Size *  
  Shorts Size  
  Cheer Tee Size Cheerleading Only
  Skorts Size Cheerleading Only
  Mock turtle neck Cheerleading Only
       
  If necessary, pick one night that your child cannot practice.
  Please enter the name of a child you wish to carpool with. (Limit 2 Names)
     
 
   
  Notes
     
  Emergency Contact First Name Emergency Contact Last Name
         
  Emergency Contact Home Phone
  Emergency Contact Work Phone
     
  I am registering my child for: Player (Football) Cheerleader  
    * *  
         
  Today's Date *    
         
 
Parent / Guardian Information
  AT LEAST ONE IS REQUIRED:
  Parent / Guardian #1      
  First Name *    
  MI    
  Last Name *    
         
  Home Phone   (XXX) XXX-XXXX
  Work Phone Work Extension
  Cell Phone    
         
  Relationship    
         
  Employer Email
         
  Parent / Guardian #2      
  First Name    
  MI    
  Last Name    
         
  Home Phone   (XXX) XXX-XXXX
  Work Phone Work Extension
  Cell Phone    
         
  Relationship    
         
  Employer Email