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Football is currently the only option as Cheer is Closed *

GirlsFlag

Football

Cheer that NEEDS to Purchase a Uniform

Cheer that ALREADY has a Uniform for Season

Please Select Today's Payment *

Only $100.00 Partial Payment

Paying in Full Today

Please note there is a ONE TIME FEE of $25.00 for Partial Payments

Please select the number of enrollments from the below options *

a) I'm only enrolling 1 child

b) This is the 1st of multiple children I'm enrolling

c) Already enrolled a child - Need to waive Participation Fee for this child

Participant's First Name *

Enter the First Name of the Player/Cheerleader

Participant's Last Name *

Enter the Last Name of the Player/Cheerleader

Participant's Date of Birth *

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

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

Football Players Current Weight

Enter the weight of the Football Player

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

Volunteer Hours (Yes or No) - See Below Explanation *

Yes

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.

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.

Registration Fee Total

Participation Fee (Included in Registration Fee)

Cheerleading Uniform Fee (Included in Registration Fee)

Paying Today via Paypal

Balance (After Paypal Confirmation of 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.

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