THE KERNERSVILLE RAIDERS
Piedmont Youth Football & Cheer League
PYCFL is a division of the AYF
Cheer Camp times are:
Sundays: 4:00pm-5:30pm
Thursdays: 6:00pm-7:30pm

Football Camp times are:
Sundays: 4:00pm-6:00pm
Thursdays: 6:00pm-8:00pm

   2019 Kernersville Raiders Football Camp Registration

 

Name of Child: ___________________________________________________

Team:          Flag    TM      MM      10U      11U    12u   13u

Address: ___________________________________________________________

Home Phone Number: __________________ Childs DOB: ___________________

Email Address: ______________________________________________________

Parent(s) Guardian(s) Name (s):

___________________________________________________________________

Phone number(s)  where you can be reached in case of emergency:

___________________________________________________________________

Current Medications: __________________________________________________

Allergies: ___________________________________________________________

EMERGENCY MEDICAL AUTHORIZATION

I hereby grant my permission for any and all emergency medical/dental treatment and/or first aid to be administered to my child/participant, including authorizing any medical treatment facility/hospital to administer emergency treatment, for any illness/injury/ accident resulting from participation in any camp.

 

Parent/Guardian Signature: ______________________________________ Date: ________________________

Payment Options:

$40.00 one time fee- includes all camp dates and camp t-shirt

$5.00 per single camp date

$10.00 for t-shirt $12.00 3XL & 2XL

T-Shirt size: Adult- 3XL   2XL   XL   L   M   S     Youth- L   M  S

 

Final date to order camp shirt will be June 30th,2019. Camp shirts will be delivered by end of camp.

( For Orgainizational Use Only)  Circle Camps Attended/Paid:

6/23   6/27   6/30   7/7   7/11   7/14   7/18

The PYFCL as a member of the AYF offers football and cheerleading to youth who are 4 by July 31st of the year they are enrolling. Due to popularity and the number of returning members, you are encouraged to fill out an interest form ASAP to stay up to date on #RAIDERNATION. Regular season practice will start July 23, 2018!   

The Kernersville Raiders was founded in 1969 and has a tremendous reputation, we look forward to you joining us! Please fill out the interest form below. 
*Your email will not be sold or abused, you will only be added to the interest list which will include a notification email when sign ups begin and a reminder in spring/summer.  
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