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FLAG FOOTBALL

22 June to 13 July

Player Information

First Name First name is required.

Last Name Last name is required.

Date Of Birth Date of birth is required.

City City is required.

Zip / Postal Code Zip/postal code is required.

Address Address is required.

Parent / Guardian Information

First Name First name is required.

Last Name Last name is required.

Cell Phone Valid cell phone is required.

Home Phone Enter a valid phone number.

Email Valid email is required.

Relationship To Child

Medical Information (Known Medical Conditions)

Emergency Contact

First Name First name is required.

Last Name Last name is required.

Home Phone Enter a valid phone number.

Work Phone Enter a valid phone number.

Cell Phone Enter a valid phone number.

Relationship To Child

Uniform Size

Jersey Size :

YXS

YS

YM

YL

YXL

AS

AXL

A2XL

Please select a jersey size.

Agreement

I certify that the above information contained in this document is accurate to the best of my knowledge.

I, the parent/guardian, grant permission for my child to participate in the specified sport.

Total Pay

$65.00

Registration Fee

$65.00 per player

Fee Includes

Jersey
Player Insurance

Coach Chris Kirby

(731) 336-8512 coachchriskirby@gmail.com

Checks Payable To

Henry County Fall Ball

Henry County Fall Ball

Coach Chris Kirby

coachchriskirby@gmail.com

2026

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Henry Co. Fall Flag Football

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