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Registration: $175

Jersey Fee: $60

Registration fees and Jersey Fees are due at fitting day. All checks are payable to NWI Coyotes.
NWI Coyotes provides all helmets/pads/and practice equipment.
All players from surrounding communities and school districts are welcome to join. Please be advised that 6 year old players may receive limited game time as they are learning basic fundamentals of the sports.
Returning Players: You have the "rights" to your jersey number. Prior year jerseys can be reused if they still fit properly and are in good shape. *A personalized game jersey is required for all players*
Practices start the first week of July. The regular season runs August - October.
We will confirm receipt of your registration - check your email for response from nwicoyotes@gmail.com
ALL participants will need to send a copy of their birth certificate to finalize registration.

Participant Name

Birthday

Grade Fall 2023

Jersey # Request

Weight

Height

Boy

Girl

Parent's Name

Parent's Phone #

Parent's Email

Parent Name

2nd Parent #

2nd Parent Email

Address

What school does your child attend?

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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