Fall Flag Sign-up Form

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Flag Fall Football Sign-up Form

* Indicates required field

Player Name *

First

Last

School *

New Player *

Yes

New player referred by *

Gender *

Boys Girls

Shirt Size *

Grade Sept 2019 *

Please list names of friends that you would like to play with. Remember we can only put so many friends per team. *

Parent Name *

Parent Phone *

Parent Email *

Can we use your child's picture in our social media and website? *

Yes No

Parent help is very important to the success of the program. Would you like to coach? *

Yes No

Select One: Payment will be $109 if submit after Sept 11 *

I’m mailing payment of $99 postmark before 9/11 I will complete the PayPal/Credit Card transaction after I submitted the form of $99 before 9/11 I'm mailing payment of $149 postmark before 9/11 for Fall & Spring Seasons ~ $50 DISCOUNT

Make Checks Payable to: NEB
Mail Checks to: NEB, PO Box 1336, Plaistow, NH 03865

Note: PayPal is online.
Submit the form to complete and or proceed with PayPal/Credit Card secure payment on the next page

Submit

Home Facilities - Haverhill, MA

978-807-6714

nebasketball@yahoo.com