2021 Orlando Anarchy Women's Tackle Football Team Registration

2024 Orlando Anarchy Women's Football

Football Registration Form
PLAYER INFORMATION
Full Name:*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone:*

Area CodePhone Number
E-Mail*
Birth Date:*

MonthDayYear
T-Shirt Size:
Can you accept text messages?
EMERGENCY CONTACT INFORMATION
Emergency Contact Full Name:*

First NameLast Name
Relationship to Player:
Home Phone:*

Area CodePhone Number
Cell Phone:

Area CodePhone Number
WAIVER INFORMATION
I hereby release the Orlando Anarchy, it’s officers, agents, and coaches from any legal or financial responsibility resulting from actions of, or injury to me while engaged in any or all of these sponsored activities (i.e. practices, games, competitions).

I also certify that I have NO HEALTH OR PHYSICAL IMPAIRMENTS which will hamper my ability to perform as a player or cause my participation to be unsafe to myself or other participants. If there are any health/physical problems the Orlando Anarchy should be aware of please indicate below:
Health/Physical Limitations (if any):
Insurance Carrier:
Policy#:
I/We agree with the above*

YesNo
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Should be Empty:

2024 Orlando Anarchy Women's Football