Document Sample
					                                            LAMBERTVILLE RAMBLERS
                                                         WARREN COUNTY LEAGUE
                                                    LAMBERTVILLE, NEW JERSEY 08530

                                       2011 FOOTBALL AND
                                   CHEERLEADING REGISTRATION

NAME:                                                       AGE:           HT:                     WT:                     DOB: ___________
                                                              (as of 9/1/2011)

ADDRESS: ______________________________________________________________________________________
               STREET                                               CITY                                STATE                                ZIP CODE

HOME TELEPHONE #:                                                  WORK TELEPHONE #:___________________________

CELL NUMBER:______________________________                           GRADE ENTERING: ________

E-MAIL ADDRESS: ______________________________

FOOTBALL TEAM:                                                                    CHEERLEADING SQUAD: ___________________
                         (Midget, Biddy, Pee Wee or Flag)                                                   (Midget, Biddy, Pee Wee, Flag)

# OF YEARS IN PROGRAM:                                       SIZE: _____________________________________________________

                                                                           Boys                                    Girls

Registration Fee Paid:                     Check/Money Order No.                           Made Payable to the Lambertville Ramblers

                                                 PARENT/GUARDIAN APPROVAL TO PLAY

I, the undersigned, being the parent/guardian of the above named applicant does hereby grant my permission for said applicant to play football or
participate as a cheerleader with the Lambertville Ramblers. We shall assume all responsibility and expense for any injury received by the said
applicant while practicing or playing in a game. I shall assume all risks and hazards incidental to the conduct of the activities. I hereby further
release, absolve, indemnify, hold harmless and waive all claims against the League, the organizers, sponsors and any supervisors in case of injury to
the said applicant. I likewise release from responsibility any person transporting said applicant to or from any league or team activities. I also
understand that I am responsible for any and all equipment issued to said applicant and agree to pay for any items destroyed through negligence or
not returned.

Signature of Parent or Guardian                                                   Date   _______________________________

Name/Policy # of Health Insurance: ________________________________________________________________

Registration Fee: $80 per child, $40 for each additional child.
Volunteer Program: At least one parent per child will be required to work the Snack Shack during the
season. (Parents may choose to “buyout” of the Volunteer time at a non- refundable fee of
$200.00 per child). If you wish to participate in the Buyout program please add this amount to the
registration fee. If you do not choose the “buyout” program you will be required to volunteer your
time in the Snack Shack or perform other necessary duties to help our program run smoothly.

If you have any questions regarding football or cheerleading, please contact me.

Jim Troutman 675 Brunswick Pike Lambertville, NJ 08530 609-397-4305 or 609-613-1245

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