REGISTRATION

Hanover Warriors Facebook

Player First Name *

Player Last Name: *

Gender *

Male Female

Player Date of Birth (MM/DD/YYYY) *

Age as of 4/1/2020? 13U- Age as of 7/31/2020 *

6U (5 & 6 years old) Date of birth 4/1/2013-3/31/2015 8U (7 & 8 years old) Date of birth 4/1/2011 - 3/31/2013 10U (9 & 10 years old) Date of birth 4/1/2009-3/31/2011 12U (11 & 12 years old) Date of birth 4/1/2007-3/31/2009 13U (13 years old as of 7/31/2019) Date of birth 8/1/2006 - 3/31/2007 14U (14 years old as of 4/1/2019) Date of birth 4/1/2005 - 7/31/2006 Cheerleading (6 - 14 year olds) Date of birth 4/1/2005-3/31/2015

Home Mailing Street Address *

City/County, VA *

Zip Code *

School where Player attends: *

Primary Contact Name *

Secondary Contact Name *

Primary Mobile Phone Number: *

Secondary Mobile Phone Number: *

Primary email Address: *

Primary Home Phone Number: *

Primary Work Number: *

Secondary email Address: *

Secondary Home Phone Number: *

Secondary Work Number: *

Primary Work email: *

Secondary Work email: *

Medical Condition or Medication: *

Yes No

If you indicated YES that there was any Medical Condition or Medications being taken please describe below: *

Spring 2020 Registration for the Hanover Warriors Youth Football League*