CCC Warriors Youth Football and Cheerleading Registration Form

If you would like to register and pay online please fill out the form below, if you prefer to pay by check please click on one of the following links to download the appropriate registration form. Football Cheerleading

Participant's First Name

Participant's Last Name

Sport

Football

Cheer

Gender

Male

Female

Age as
of 8/1/12

Birthdate
(xx/xx/xxxx)

Football Player
(Weight)

Cheerleader
(Shoe size)

Years of
Experience

Were you referred to register with
the Warriors from a current athlete?

Yes

No

If yes, by whom? (list athlete's full name)

Additional registrants - if ncessary

Participant 2 First Name

Participant 2 Last Name

Sport

Football

Cheer

Gender

Male

Female

Age as
of 8/1/12

Birthdate
(xx/xx/xxxx)

Football Player
(Weight)

Cheerleader
(Shoe size)

Years of
Experience

Participant 3 First Name

Participant 3 Last Name

Sport

Football

Cheer

Gender

Male

Female

Age as
of 8/1/12

Birthdate
(xx/xx/xxxx)

Football Player
(Weight)

Cheerleader
(Shoe size)

Years of
Experience

Parent/Guardian's First Name

Parent/Guardian's Last Name

Phone Number

Email Address

Parent/Guardian Information

Street Address

City

State

Zip Code

Emergency Contact Name

Emergency Contact Phone Number

How did you hear about the Warriors?

Payment Information

Earn A Refund Check of up to $30.00.

"Refer a friend! If your friend registers to participate with the CCC Warriors Football and Cheerleading Program during the 2012 season, you will receive a $10.00 refund per registered referral (maximum $30.00).

List your friends below along with their contact information, or refer them to this registration site and tell them to enter your name in the "referred by" field."

Pay by Credit Card/Paypal

Upon submission you will be directed to a Paypal site. You may pay using a paypal account or as a guest where you can use any credit/debit card or the Bill Me Later feature.

Football Player ($155 + $5 admin fee)

Cheerleader ($190 + $6 admin fee - includes shoes)

Football Player Family 2 athletes ($290 + $10 admin fee)

Cheerleader 2 athletes($360 + $12 admin fee - includes shoes)

1 Football Palyer + 1 Cheerleader (325 + $12 admin fee - includes cheer shoes)

Refer A Friend

Refer a friend who registers to participate with the CCC Warriors Football and Cheerleading Program during the 2012 season and receive a $10.00 refund. You may refer as many athletes as you would like; the maximum refund is $30.00. A check will be issued once the athlete has registered and paid to participate with the Warriors during the 2012 season.

Potential Athlete's Name

Phone Number

Sport

Potential Athlete's Name

Phone Number

Sport

Potential Athlete's Name

Phone Number

Sport

Indicates Response Required