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Registration has been Extended for the 2023 Season!

Registration: $75

Uniform Fee: $60

Registration fees and Uniform Fees are due at fitting day. All checks are payable to NWI Coyotes.
All athletes from surrounding communities and school districts are welcome to join.
Practices start the first week of July. Practice will be start as 3 days a week the first month and transition to 2 days a week as the season goes on. The regular season runs August - October with 8 regular season games.
We will confirm receipt of your registration - check your email for response from nwicoyotes@gmail.com

Participant Name

Birthday

Grade Fall 2023

Boy

Girl

Parent's Name

Parent's Phone #

Parent's Email

Parent Name

2nd Parent #

2nd Parent Email

What school does your child attend?

Address

Emergency Contact Name

Emergency Contact Number

INSURANCE WAIVER This is to certify that my child has my permission to participate in the NWI Coyotes program. This is to certify that I as the parent or guardian of the above named person will assume the financial responsibility in case of injury and certify that the above named person has medical/accident insurance coverage and that NWI Coyotes (including coaches, refs, participants, and volunteers) is not responsible for any medical costs arising from such injury. I consent to treatment of my child at the emergency room in Freeport, IL or any other medical institution if he/she is taken there at the direction of the NWI Coyotes. I am not aware of any physical or mental condition or restriction that would prevent my child from participating in the NWI Coyote Football/cheerleading programs. I have reviewed this completed form and affirm that it is correct.

Your Signature

Thanks for registering!

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