REGISTRATION
Welcome to the Madison (&Harding) Junior Football Player and Cheerleader registration page. This form facilitates the collection of required information and fees in accordance to the below table. Your payment will be processed securely through Paypal and your information carefully maintained for privacy. Please make sure you complete and receive a confirmation from PayPal. Hold on to this confirmation as verification of your payment. Your information will be used exclusively by the coaching staff to coordinate and manage the league football and cheerleading programs. Please take your time to complete the data as accurately as possible and finalize your payment in order to secure your child’s place within the upcoming season’s roster. Please note that a late registration fee of $50 will be mandated according to the below schedule.

SCHEDULE:
Standard Registration Deadline: June 30th
Late Registration Deadline: (Standard +$50) July 15th
Registration Closed: July 16th and beyond (exceptions will not be made).

FEES:
1 Child 2 Children 3 Children
Cheerleading $75 $125 $175
Flag $50 $75 $125
Football $100 $175 $250
Late Registration Fee: $50



NUMBER OF REGISTRATIONS:
CHILD'S FIRST NAME LAST NAME
BIRTH DATE
GRADE IN SCHOOL AS OF THIS FALL
ACTIVITY (PLEASE SELECT ONE)
# OF YEARS IN LEAGUE
LAST LEVEL ENROLLED LEVEL REGISTERING
CHILD'S STREET ADDRESS
CHILD'S TOWN CHILD'S ZIP
PARENT/GAURDIAN INFORMATION
PARENT/GAURDIAN 1
FIRST NAME LAST NAME
STREET ADDRESS
TOWN ZIP
TELEPHONE
E-MAIL

PARENT/GAURDIAN 2
FIRST NAME LAST NAME
STREET ADDRESS
TOWN ZIP
TELEPHONE
E-MAIL

EMERGENCY CONTACT
FIRST NAME LAST NAME
TELEPHONE
BY ADVANCING REGISTRATION BEYOND THIS PAGE, I HEARBY GIVE MY SON/DAUGHTER PERMISSION TO PARTICIPATE IN ALL ACTIVITIES SPONSERED BY THE MADISON JR. FOOTBALL PROGRAM AND FURTHER AGREE TO ACCEPT FULL RESPOSIBILITY FOR ANY INJURY RESULTING THEREFROM. I FURTHER AGREE TO HOLD SAID ORGANIZATION HARMLESS BECAUSE OF HIS/HER PARTICIPATION. HE/SHE HAS BEEN EXAMINED RECENTLY BY A PHYSICIAN AND TO THE BEST OF MY KNOWLEDGE, IS PHYSICALLY FIT TO PARTICIPATE IN ORGANIZED FOOTBALL/CHEERLEADING.