Please fill in all fields marked with a *
Player's First Name *
Last Name *
Date of Birth * MM/DD/YYYY
Age as of July 1st 2010
Team
Street Address *
City *
State *
Zip *
Email Address *
Home Phone *
Cell Phone *
Grade as of Sept 2010 *
School You Will Be Attending *
Gaurdians Names *
Emergency Contact *
Emercgency Phone *
Prior Experience *
Shirt Size *
Volunteer Volunteers are what make our organization work. We need your help. It is MANDATORY that All Parents/Guardians help during the season. Please select the activity that you would like to help with and we will do our best to give you time with that crew

*
I Agree

I, the undersigned, do hereby agree for myself and my family to appear in photographs or video of Drexel Hill Raiders A.A. activities to be used by The Drexel Hill Raiders for the purpose of public relations, advertising, and general publicity for the Drexel Hill Raiders A.A.

*

              

We are in need of medical personnel: R.N., E.M.T., M.D. To volunteer during our games.
Please Notify Jim Pierucci at dhr_football@yahoo.com If you can help
 
For problems or questions with this form please contact Jim Pierucci at dhr_football@yahoo.com