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Registration Form

Registration Procedure

  1. Complete the entire Registration Form (including medical history) below, and submit it.
  2. Come to one of the registration nights with you payment of the $50 registration fee.

Cheques should be made payable to Bulldogs Football Association. This fee includes the mandatory Football Alberta Insurance payment, Bulldogs T-shirt, fee for Spring Camps and the player evaluation fee.

NOTE: All documentation and payment of fees MUST be completed and handed in before the player participates in any on-field or team activities. All information is confidential and will only be shared with Bulldogs Football Association personal and with Football Alberta.

PARENT(S)/GUARDIAN(S) PLEASE READ THE FOLLOWING:

I understand that I am responsible for notifying the Team Management staff of any changes to the information provided as soon as possible.

I understand that in the event the player named on this form is injured and requires medical attention and the individuals listed above cannot be contacted, Team Management will take the player to the Hospital or Medical Centre, if deemed necessary. Depending on the seriousness of the injury, this may involve transportation via an Ambulance. Bulldogs Football will not be responsible for Ambulance charges. I hereby authorize the team Trainer or Coaching Staff to undertake examination, investigation and to provide the necessary treatment to my child.

I authorize the release of information regarding my child to appropriate people (Coaching Staff, Trainer, Physician, etc.) as deemed necessary by Team Management.

** ALL MEDICAL INFORMATION WILL BE KEPT CONFIDENTIAL AND WILL ONLY BE AVAILABLE TO AUTHORIZED PERSONNEL **


Family Information

Player's name

Parent(s) name(s)

Home address

Community

City

Postal code

Home phone number

Cell phone number

Work phone number

Family email address 1

Family email address 2

Emergency contact

Emergency contact phone #

Emergency contact address

Relationship

Player Information

Birthday

Age

Height

Weight

School

Grade

Football experience

Other sports experience

Refferred by

Where did you hear about Bulldogs Football?

Medical History

Previous concussions?  yes no
Fainting Episodes?  yes no
History of Epilepsy?  yes no
History of Asthma?  yes no
Wears Braces?  yes no
Medication?  yes no
Presently Injured?  yes no
Hearing Problems?  yes no
History of Diabetes?  yes no
Heart Condition?  yes no
Wears Glasses?  yes no
Wears Contact Lenses?  yes no
Allergies?  yes no
Other issues?  yes no

Additional Medical Details

Medications

Allergy Details

Recent Injuries

All medical conditions or physical injuries should examined by your Physician prior to the start of conditioning sessions and contact drills.

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