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Passaic County Cougars


Click Here to Download the Registration Form
PC COUGARS
FOOTBALL
2025 Registration Fee Form
Player Information Parents/ Guardian Information
Name:___________________________ _ Name:
Address:____________________________ Address:
City,ST,Zip: City,St,Zip:
Phone: Cell:
Cell: E-Mail:
DOB: Notes:
Weight: Height:
Parent / Guardian Information
I, the undersigned parent / guardian, wish to register the child indicated above in the Passaic County Cougars, Inc organization. I give permission for the coaches to administer first aid and to authorize emergency treatment by a doctor if necessary. I am aware of the risky of injury in any sport and hereby release The Passaic County Cougars Inc. and its coaches referees and other associated personnel from any claims. The child is medically fit to play sports. I also certify that the dated of birth information provided above is true to the best of my knowledge
Signature of Parents / Guardian: Date:
Registration Fee Payment Options PAY ONLINE
1st Payment: Date: Amt. Pd Bal: P.I.F:
2nd Payment: Date: Amt. Pd Bal: P.I.F.
3rd Payment: Date: Amt. Pd Bal: P.I.F:
Final Payment: Date: Amt. Pd Bal: P.I.F.
Discounts: Multiple Child 2 or more = $20 off Registration CASHAPP ZELLE
Discounts are based on the total fees due. If utilizing the payment plan, the discount will be reflected on the final payment and there's absolutely no combining of discounts
Circle appropriate age group &
Registration Fees
Age Groups Registration Fee5
5- 7 yrs old $130.00 Flag
7-8 yrs old $275.00 tackle
9-10 yrs old $275.00 tackle
11-12 yrs old $275.00 tackle
12-13 yrs old $750.00 tackle
NO REFUNDS
REQUIRED
DOCUMENTS
NEEDED
​
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BC:
EQUP:
PHY:
PHY EXP DATE PHOTO
/ /
VA:
PPA:
PR:
CCF:
MCF:
OFFICIAL USE ONLY: Reg fee pay online
1st 2nd 3rd Final
Date of refund: Refund Amount: $
Reason:
Signed By:


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