Bishop McNally/Father Lacombe Football
Football Registration

Please fill out the information below and follow the instructions below.

Last Name:

First Name:

Address:

City:

Province:

Postal Code:

Home Phone:

Email:

Grade:

Date of Birth:
Day/Month/Year

Football Background

Have you ever played before?

Yes No

Team:

Weight:
lbs.

Height:
ft.

Desired Position:

Desired Numbers: List 3 jersey numbers you would like to have

Team I am registering for:

Senior Junior

Medical History

Previous Injury: (sprains, strains, fractures, torn muscles, ligament injuries, dislocations)

Yes No

If yes, please describe:

Medical Conditions: (asthma, diabetes, other)

Medications:

Alberta Health Card Number:

Family Physician:

Phone Number: