For full functionality of this site it is necessary to enable JavaScript.
OUR SERVICES
FREE
Web Sites
FREE
Online Registration
Payment Processing
LeagueLineup Pro & Elite
Domain Names
Background Checks
LOCAL SPORTS
Find a Web Site
Tournaments
Team Tryouts
Sports Photographers
ELITE
LeagueLineup Elite
Create your own site
Close Panel
NOW ENTERING PANTHER COUNTRY
NORTH CROWLEY PANTHERS PEEWEE
Login
MyLeagueLineup
Administration
Login
MyLeagueLineup
Administration
°F
THE FUTURE IS NOW!!!
About
Bulletin Board
Photo Albums
Board Members
Schedules
Schedules
Panther Calendar
Directions
Results
Game Results
Standings
Forms
Online Forms
More
Guestbook
Video Training
Pages
American Youth Football-Member
Cheerleading Program
Login
MyLeagueLineup
Administration
Subscribe to our Newsletter
FOOTBALL (TACKLE REGISTRATION ONLY) Ages 6 - 13
PLAYER INFORMATION
*
First Name:
*
Last Name:
*
Street:
*
City:
*
State:
Zip Code:
*
Home Phone:
*
Birthdate:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
*
Age:
*
Gender:
M
F
*
School Player Attends:
Grade:
K
1
2
3
4
5
6
7
8
9
10
11
12
PARENT/GUARDIAN #1
*
Firstname:
*
Lastname:
*
EMail:
*
Home Phone:
Work Phone:
Cell Phone:
PARENT/GUARDIAN #2
Firstname:
Lastname:
Email:
Home Phone:
Work Phone:
Cell Phone:
MEDICAL/EMERGENCY CONTACT INFORMATION
*
Emergency Contact:
*
Phone:
Relationship to Player:
Insurance Carrier:
Policy #:
Doctor's Name::
Doctor's Phone:
*
List any medical conditions that may affect participation::
WAIVER INFORMATION
PARENT MEDICAL AUTHORIZATION:
I, the parent/guardian of the above named child, do hereby give permission to the managing personnel or other association representatives to authorize and obtain medical care for the above named child, from any licensed physician, EMT, hospital, or medical clinic, should the participant become ill or injured while participating in league sponsored activities when neither parent is available to grant permission for emergency treatment.
I agree with the above statement:
*
PARTICIPATION ACKNWLEDGEMENT
I, the parent or guardian of the above named child, do hereby give approval for his/her participation in any and all North Crowley Youth Association sponsored activities during the current season. I assume all risks and hazards incidental to such participation including transportation to and from activities, and do hereby waive, absolve, indemnify and agree to hold harmless the North Crowley Youth Association Board of Directors, coaches, organizers, sponsors, supervisors, participants and person transporting the participant to and from activities, for any claim arising out of an injury to the participant, except to the extent of the amount covered by accidental and/or liability insurance by the association.
I agree with the above statement:
*
INTERNET/NEWSPAPER RELEASE
I authorize North Crowley Youth Association to publish pictures and/or names of my child/children participating in North Crowley Youth Association games and/or activities on the North Crowley Youth Association website, www.ncya.org and/or local newspaper.
I agree with the above statement:
*
PAYMENT OF FEES
I, the parent or guardian of the above named child, do hereby acknowledge and accept the fees required to participate in NCYA programs. I understand that failure to meet payment deadlines could result in a delay in ordering the above named child’s uniforms.
I acknowledge that $50 registration fees are non-refundable. I understand that once a NCYA uniform has been ordered for the above named child no refunds will be made.
I understand that the standard NSF rates apply for all insufficient checks returned to North Crowley Youth Association.
I agree with the above statement:
* indicates required fields
