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

Do you have SORE FEET?? Let the professional team at Pistone Foot Center help you to have Happy Feet. www.pistonefootcenter.com 978.556.9750

Home Facilities - Haverhill, MA

978-807-6714

nebasketball@yahoo.com