PLEASE PRINT LEGIBLY
GRADE/FALL 2010     CIRCLE ONE:    SENIOR     JUNIOR     SOPHOMORE     FRESHMAN
Players Name_________________________________________________________________________					Player Cell#	_____________________	_________________________
(as you want their name printed on the football roster)
Address:_____________________________________________________________________________	_______________________________________________________________________						_________________________
City/Zip Code___________________________________________				Phone#____________________________________			_________________________
E-mail:(print the primary email address that you want football info sent to)_____________________________________________
Dad Name___________________________________________________________________________							_________________________
Address(if different than above)_______________________________________________________________
City/Zip___________________________________			Phone#(if different than above)________________________________
Cell#______________________________________				Work#_____________________________________
E-mail Address_______________________________________________________________________							_________________________
(only if you want football e-mails sent to this address also)
Occupation__________________________________________________________________________							_________________________
Mom Name__________________________________________________________________________							_________________________
Address(if different than above)______________________________________________________________							_________________________
City/Zip___________________________________			Phone#(if different than above)_______________________________				_________________________
Cell#_____________________________________				Work#_____________________________________			_________________________
E-mail Address_______________________________________________________________________							_________________________
(only if you want football e-mails sent to this address also)
Occupation__________________________________________________________________________							_________________________
Stepdad Name______________________________				Stepmom Name_____________________________			_________________________
Work#_____________________________________				Work#_____________________________________			_________________________
Cell#______________________________________				Cell#______________________________________			_________________________
Occupation_________________________________				Occupation_________________________________			_________________________
E-mail Address______________________________				E-mail Address______________________________			_________________________
(only if you want football e-mails sent to this address also)				(only if you want football e-mails sent to this address also)
PLEASE INITIAL IF YOU DO NOT WANT THIS INFORMATION SHARED WITH OUR
FOUNDATION AND BOOSTERS CLUB TO CREATE AN ATHLETES DATA BASE