FlagApplication Please Complete the Entire Form.The fields with an Asterisk (*) are require fieldsOnce completed, the information will automatically be transferred to the Rush Application, which will be immediately sent to you via email in an attached PDF File after your payment has been completed.After you hit Submit, you will be sent to PayPal for payment to complete the registration process. You can pay via a PayPal Account OR via Credit Card as a PayPal GUEST. You will receive a Registration Complete email with the PDF File ONLY after payment is complete. 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 * Youth SmallYouth MediumYouth LargeYouth X-LargeAdult SmallAdult MediumAdult LargeAdult X-Large 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 * signature keyboard 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. --> Submit & Make Payment <-- If you are human, leave this field blank. 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.
