Youth Football Registration

Player First Name
Player Last Name
Gender
Email
Birth Date
Grade as of Sept. 2011
Jersey Size
Address Location
Address
Apt., Suite, etc.
City
State
Zip
Phone
Favorite NFL Team
Volunteer Coach	Yes No
For car pooling considerations, please indicate other player(s) your daughter/son would want to be placed with

Attention Parents:

To the best of my knowledge, my child is in good physical condition, has no illness, conditions, impediment, or handicap which would prevent him/her from fully participating in the programs offered by the Get in Shape Long Island Ltd. and Recreational Sports Leagues, Inc. and my child has my permission to participate.
In consideration of the benefits derived form membership, we voluntarily waive any claims against Get in Shape Long Island Ltd. and Recreational Sports Leagues, Inc it’s chartered members and institution, it’s sponsors, and all leaders of the Get in Shape Long Island Ltd. and Recreational Sports Leagues, Inc. for any and all clauses that may arise in connection with the activities of the above organization.

Please download Terms and Conditions Form by clicking here.

This form must be filled out and returned to the league before the season starts.

Mail checks and money orders in the amount of $92 to:

Get in Shape Long Island, Ltd.
PO Box 723
East Northport, NY
11731-1204

Please write child's name and phone number in note area of check
and include copy of signed waiver.