Flag Football - Elmwood Park Rush Football | Chicago Youth Football | Chicagoland Youth Football | Chicago Pop Warner Football

FlagApplication 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

Sport Selection *

Flag Football

Participant's First Name *

Enter the First Name of the Player

Participant's Last Name *

Enter the Last Name of the Player

Participant's Date of Birth *

Enter the Birth Date of the Participant (MM/DD/YYYY)

Shirt Size

Participant's Age on September 1st *

Enter the Age that the Participant will be as of July 31st of the Current Year

Participant's School Grade *

Enter the School Grade that the Participant will be entering this fall

Participant's Home Address *

Enter the home address of the Player/Cheerleader

Participant's City *

Enter the City of the Player/Cheerleader

Participant's State *

Enter the State for the Player/Cheerleader

Participant's Zipcode *

Enter the Zipcode for the Player/Cheerleader

Participant's Home Phone Number

Enter the Home Phone Number for the Player/Cheerleader

Participant's Cell Phone Number

Enter the Cell Phone Number for the Player/Cheerleader

Participant's Medical Condition

Enter any Medical Conditions that you feel we should be aware of.

Parent/Guardian's First Name *

Enter the First Name of the Legal Parent and/or Guardian

Parent/Guardian's Last Name *

Enter the Last Name of the Legal Parent and/or Guardian

Parent/Guardian's Home Address *

Enter the Home Address of the Legal Parent and/or Guardian

Parent/Guardian's City *

Enter the City for the Legal Parent and/or Guardian

Parent/Guardian's State *

Enter the State for the Legal Parent and/or Guardian

Parent/Guardian's Zip Code *

Enter the Zip Code for the Legal Parent and/or Guardian

Parent/Guardian's Email Address *

Enter the main email address for the Legal Parent and/or Guardian

2nd Parent/Guardian Email Address (optional)

If there is a 2nd email, please enter for communication

How were you referred to the Elmwood Park Rush? *

Please enter how you heard about the Elmwood Park Rush

Signature *

Clear

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 & MERGE 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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