Passaic County Cougars

PC COUGARS
FOOTBALL 2022 
2022 Equipment, Uniform & Fee Form
Player & Parent Contact Information
Player Name:                                                                                  
Parent Name:                                                                                   
Address:                                                                                           
City, St., Zip                                                                                       
Home#:                                             Cell#:                                        
Equipment Information
Helmet Sizes:                    Helmet Serial Number:                   
Shoulder Pad Sizes:                        Shoulder Pad Number:                        
Uniform Information
Jersey Size:                        Jersey Number:                     Pants Sizes:                    
*** All new players are to select a minimum of 3 choices for Jersey number and will br assigned the first available number*** 
Fee Information
Registration Fee Paid: $                                 Balance: $                    
Divisions:   Circle one
5 - 8 flag       9u     10u        12u         13u     
The game uniform remains the property of the organization and will be collected at season end.
The Helmet & Shoulder pads remain the property of the organization and will be collected at season end.
Parent/Player are responsible for damage to game uniform & Equipment in excess of normal wear & tear.                 
                 Signature of Parent / Guardian:                                                                                                Date:                                        
If equipment is lost or damaged replacement cost will be : 
Helmet = $200 Shoulder pads = $100  Game Jersey = $80  Game Pants = $60