<!--[if !vml]--><!--[endif]-->    Georgia Raiders Pro Football

                                                  Stone Mountain Ga, 30088      

                                                           (404)418-2251           

                                              www.georgiaraiders@ymail.com

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 Participation Registration Form

                                                                     Registration Fee is determined by postmarked date.

<!--[if !vml]--><!--[endif]-->Player Information – print legibly

 

Players Last Name: ___________________First Name: ________________DOB: _________ Gender ______

Street Address________________________________ Home Phone_________________ Email___________________

City/State/Zip ________________________________________________ Cell: __________

College Attended: _______________________________Place of Employment ____________________ 

Last Team Played At_________________ Total years played______________

Position _________ H’T _____________ Est. Weight (Football only) __________

Player/Cheerleader/Dancer Emergency Contact Information (please be complete as possible)

 

Medical Information

 

 IMPORTANT NOTE:  If the player is under medical care or is on prescribed medication, a note from his/her physician is required.

<!--[if !vml]--><!--[endif]-->Terms of Player Contract

 

No Refunds.  Game Jersey’s will be issued when full registration payment is received.  Players will not be allowed to participate in the

 Georgia Raiderst Pro Football program if payment is not paid in full.  Fees include rental of Game uniform, Stadium rental, Referee fees & some but not all travel cost. All players must participate and team fundraisers to help off set cost. Players must provide their own equipment such as helmet, shoulder pads ECT. Any Uniforms or equipment issued by the Georgia Raiders are the property of  Georgia Raiders Pro Football and must be returned by the end of the season. I agree to pay the cost of any lost equipment issued to me by the Georgia Raiders .

Medication Authorization & Grant of Consent:  I hereby certify that I am in good health and may participate in all activities. In case of an emergency, I give my permission to be given emergency treatment at any responsible accessible hospital.

Liability Waiver: I _______ assume all risk and hazards incidental to such participation, including transportation to and from such activities, and do hereby release and waive all claims against Georgia Raiders Pro football. I Understand Georgia Raiders do not carry accident insurance.

Signature of Player / Guardian ___________________________ Print Name ___________________________Date ______________