2021 Football Player Registration Form

* Required Fields
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Fee: $75.00
This is the payment registration form for St. Philip's football.  Ages are 4 thru 12.  The deadline to register and pay is August 14th.   The program is offered in partnership with Pop Warner.  For your registration to be complete, you must both complete this online payment form, make payment, and download, print, and submit the Pop Warner registration forms below.
            
 The participant registration fee is $75. If you elect to pay your registration fee online using a debit or credit card, you will be prompted to do so once you complete this form and your registration will be complete once this form is submitted, the Pop Warner form is submitted and the online payment is made.  If you elect to pay in person, you must complete this registration form and then submit a money order or cashier's check to St. Philip's School & Community Center with both your name and the child's name referenced.  Registration and payments must be received by August 14th. 
Participant Information
*First Name
*Last Name
*DOB
mm/dd/yyyy
*Current Age
Parent / Guardian 1 Information
*Guardian 1 First Name
*Guardian 1 Last Name
First Name
Middle Initial
Last Name
Street Address
City
State
Don't type in this field
Zip Code
Email
Daytime Phone
Evening Phone
Mobile Phone
*Valid Email Address
Waiver
Waiver
I hereby grant permission to representatives of St. Philip's School & Community Center to provide care to my child in the event of injury or illness if I am not present.  Such care may include but shall not be limited to first aid treatment, transporting to a medical facility, or the summoning of emergency assistance.  I, the parent or appointed guardian of the above named child, hereby agree to indemnify and hold harmless St. Philip's School & Community Center and its officials, directors, managers, coaches and assistants from any liability for the above named child's activities of any nature with said organization.
*Waiver confirmation
 I have read and agree with the waiver. 
Refund Policy
The Policy
All Fees are  non refundable. 
*Refund confirmation
 I have read and understand the refund policy. 
Statistics
Payment Modification Code
 
*Valid Email Address
*Gender
*Ethnicity
*Race
Total Due:
$ 
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