Fall Flag Sign-up PayPal Form

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Flag Fall Football Sign-up Form

Player Name *

First

Last

Town or School *

New Player *

Yes No

If new player who referred you? (Needed to qualify for raffle) *

Gender *

Boys Girls

Shirt Size *

Grade Sept 2017 *

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

Our program has grown every year because of the help our parents and from their referrals. Please give us any new players parents email addresses that you may think would enjoy our program. *

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

Yes No

To Mail a check: *

I’m mailing full payment of $115 (Early Bird discount) if postmarked before September 8th I’m mailing full payment of $125

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

Submit

Early Bird Special Save 10%

Home Facilities - Haverhill, MA

978-807-6714

nebasketball@yahoo.com