North Parkland Athletic Association Registration Form
(Print the form and complete the information required.)

Player's Name: _____________________________________ 

Birthdate:__________________

School: ____________________  Current Grade: __________

Father/Mother: ____________________________________ 

Phone #: __________________ Cell #: _________________

Street Address: ____________________________________

City: _________________________  Zip: _______________

North Parkland Athletic Association will not be responsible for any medical or dental injuries in any sports, but does carry liability insurance for transportation to and from games.  

Sport: _______________________ 

Parent/Guardian Signature: _____________________________ 

Date: ____________

Registration Fee is $60.

□ Paid                 □ Birth Certificate