2021 Flag Football Clinic Registration

Evenings 6:00 – 8:30 pm
Sunday, July 25 – Tuesday, July 27

Learn basic skills, plays, and positions of Flag Football
Open to boys and girls entering 2nd through 5th grade
Participants receive a t-shirt and football
Registration fees are $25 per child
Registration deadline is Monday, July 12

Parent First Name *

Parent Last name *

Primary Email Address (to receive updates) *

Secondary Email Address (to receive updates)

Emergency Phone Number *

Home Address (Street) *

City *

State *

Zip Code *

Number of Children Attending *

My child may be photographed *

How did you hear about us?

What church do you attend?

First Child

Child #1 First Name

Child #1 Last Name

Child #1 Grade (in fall 2021)

Child #1 T-shirt Size (Youth sizes)

Second Child

Child #2 First Name

Child #2 Last Name

Child #2 Grade (in fall 2021)

Child #2 T-shirt Size (Youth sizes)

Third Child

Child #3 First Name

Child #3 Last Name

Child #3 Grade (in fall 2021)

Child #3 T-shirt Size (Youth sizes)

Fourth Child

Child #4 First Name

Child #4 Last Name

Child #4 Grade (in fall 2021)

Child #4 T-shirt Size (Youth sizes)

Allergies, medical conditions, medications, or any considerations regarding your child’s health (reference child # above)

I, the legal parent/guardian, grant my permission to attend the Gloria Dei Lutheran Church Volleyball Camp. I hereby release Gloria Dei Lutheran Church from any and all liabilities in case of accident or illness. I authorize any medical care deemed necessary by an accredited physician, nurse, medical personnel, or hospital while attending the Volleyball Camp.