2004                                                                                               

                  FPD VIKING  FOOTBALL

               & CHEERLEADING LEAGUE

               (2ND, 3RD,4TH & 5TH GRADES)

 

                                             REGISTRATION  FORM

 

Name:___________________________________  Football _____  Cheerleader _____

Date of Birth: ___/___/___    Grade:_______   School __________________________

Parent’s Name(s): _______________________________________________________

Address: __________________________________________,GA zip:_____________

    Telephone #:  Home: _____________________          Work:  __________________

                           Cell:    _____________________           E-Mail: _________________

Fees:                                                                                                                                    

               Football:          FPD Student:   $90.00         Non-FPD Student:   $100.00

               Cheerleading:  FPD Student:   $75.00         Non-FPD Student:     $85.00

 

Make check payable to FPD Football & Mail To:     Please Provide:                                                                       

        First Presbyterian Day School                               Football:  Height   ___’___”

        Viking Football League                                                      Weight  ______lbs                                                         

        5671 Calvin Drive                                               Please Circle Apprx. Youth Size:

        Macon, GA  31210                                              Cheerleader:   XS  S  M  L  XL                                                    

Yes! I am interested in:       COACHING _______    TEAM MOM ______ 

 

Name: __________________________________     Telephone #: _________________        

 

2nd & 3rd Grades:   Football  practice on Mondays @ 6:00 PM for 1 ½ Hours.

4th & 5th Grades:    Football  practice on Tuesdays @ 6:00 PM for 1 ½ Hours.

             Cheerleaders will practice immediately after school on Fridays.

All games will be played on Saturday mornings except for one special Friday night.

Practices begin in late August with games played in mid-September through October. Any football questions, please call Bobby Gerhardt @ 474-7086 or e-mail him at rhgerhardt@aol.com or cheerleading questions, please call Lori Harden @ 477-0225.

                                                                                  -----------------------------------

 

I hereby give approval for the participation of my child, whose name appears above, in any and all 2004 Viking Football League (VFL) activities and assume all the risks and hazards associated with incident to such participation, including transportation to and from VFL activities.  I understand that, although this is a recreational league, the possibility of an accident or injury involving my child does exist.  I further understand that FPD’s student accident insurance coverage, if my child is an enrolled FPD student,  is a secondary catastrophic plan, and will only take effect after my personal insurance has been exhausted and the school student accident policy’s deductible has been satisfied by me or my insurance provider.

 

 

PARENT/GUARDIAN  ________________________________DATE ______________

               DEADLINE:   FRIDAY,  AUGUST 20, 2004