RushApplication
Please Complete the Entire Form.

Once completed, the information will automatically be transferred onto the Rush Application, which will be immediately be available for you to download, and will be sent to you via email.

The fields with an Asterisk (*) are require fields

Please note there is a ONE TIME FEE of $25.00 for Partial Payments
Enter the First Name of the Player/Cheerleader
Enter the Last Name of the Player/Cheerleader
Enter the Birth Date of the Participant (MM/DD/YYYY)
Enter the Age that the Participant will be as of July 31st of the Current Year
Enter the School Grade that the Participant will be entering this fall
Enter the weight of the Football Player
Enter the home address of the Player/Cheerleader
Enter the City of the Player/Cheerleader
Enter the State for the Player/Cheerleader
Enter the Zipcode for the Player/Cheerleader
Enter the Home Phone Number for the Player/Cheerleader
Enter the Cell Phone Number for the Player/Cheerleader
Enter any Medical Conditions that you feel we should be aware of.
Enter the First Name of the Legal Parent and/or Guardian
Enter the Last Name of the Legal Parent and/or Guardian
Enter the Home Address of the Legal Parent and/or Guardian
Enter the City for the Legal Parent and/or Guardian
Enter the State for the Legal Parent and/or Guardian
Enter the Zip Code for the Legal Parent and/or Guardian
Enter the main email address for the Legal Parent and/or Guardian
If there is a 2nd email, please enter for communication
No = I do not plan to complete the required 15 volunteer hours to be reimbursed the $100.00 participation fee. Please accept my $100.00 participation fee as a donation towards the cost of event activities or scholarships.

Yes = I plan to work the required 15 volunteer hours so that I may be reimbursed the $100.00 participation fee. I understand that ALL hours MUST be logged with the Official Volunteer Coordinator; and that it’s totally my responsibility to ensure my hours are officially logged as my volunteer work/time occurs.
Please enter how you heard about the Elmwood Park Rush
By drawing and/or typing your name here, you are signing this application electronically. You agree your electronic signature is the legal equivalent of your manual signature on this application.
Once you hit SUBMIT below, please note that it may take time to populate on the Rush Application. Once the system is done updating, you will be sent to a confirmation page with a button for PayPal to make your payment. You will receive an email with the Application attached, and will be able to download the application for your records.

Please also note that your application will NOT be received by the Elmwood Park Rush until you get a Confirmation of Payment from PayPal. SO PLEASE MAKE SURE YOU WAIT FOR THE PAYPAL PAGE TO FINISH THE APPLICATION PROCESS.
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