Player Photo

2Ó X 2Ó
 
New York Rebels Football

Registration Form

 

 

Registration fee $25.00

 

Player Profile           Returning Player:              New Player:      

 

First Name:                                         Last Name:                                               Phone: (     )                           

Address:                                                                                                               Cell:(     )                                 

City:                                               State:               Zip:                  Email:                                                          

Date of Birth:         /         /             Place of birth:                                    

*Desired Position:                        

 

In case of an emergency notify

 

Name:                                                   Relationship:                               Phone:(     )                                     

Name:                                                    Relationship:                               Phone:(     )                                     

Medical History, medication and/or injury:                                                                                                      

 

Athletic Information

 

Height:                   Weight:              Age:             

40 Time:               Bench Max:            Squat Max:                Vertical Jump:            

 

Football Experience

 

Position(s) Played: OFFENSIVE                       DEFENSE                    SPECIAL TEAMS

                                      Quarter Back                           Corner                                 Kicker

                                       Running Back                           Safety                                   Punter

                                     Wide Receiver                           Linebacker                            Long Snapper

                                       Tight End                                   Def. End

                                      Center                                        Def. Tackle

                                       Guard                                        Nose Tackle

                                      Tackle

                                                                                                                                              Years  

                                                           Team                                   Position                     Played

Professional:                                                                                                                    

Semi-Pro:                                                                                                                          

College:                                                                                                                           

High School: