PLAYER REGISTRATION | Virginia Lions

PLAYER REGISTRATION

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Players wishing to play for the VIRGINIA LIONS, Fill out our application now! Feel free to contact us with any questions. VALIONSFOOTBALL@hotmail.com

Football Application

First Name: *

Please enter your first name

Last Name: *

Please enter your Last name

Nick Name:

Please enter a Nick name or what you preferred to be called.

Address

Enter your address

Street Address: *

Please enter your current street address of place of living.

City: *

Please enter the city you live in.

State:

Zip Code:

Enter your zip code

Phone Number: *

Please enter a valid phone number we may reach you at.

Cell Number: *

Please enter a valid Cell phone number we may reach you at.

E-mail:

If you have access to e-mail, please put your email address

Birthday: *

Please enter the your birthday

Employer Name:

Please enter the name of your employer.

Occupation:

Please type your current occupation

Emergency Contact Information

Enter an emergency contact we can call in case of an emergency

First Name: *

Last Name: *

Phone Number: *

Medical Insurance Company Name:

Please type the Name of your Policy holder

Policy Number:

Please enter your policy number

Football Information

(Please list all accomplishments, awards, statistics, team names, school names, and league names below.)

Height: *

Please enter your height

Weight: *

Please enter your current weight

Played Position:

Please select your last played position, or perferred positions. (Note: the Virginia Lions reserve the right to place any player in any position they feel best fits over team chemistry)

Experience:

Enter how many years you have played Football beyond the highschool level. If none, put none.

Description: *

Please write a brief description about yourself as a football player. If you put down some experience, please put a brief description of that experience.

CAPTCHA

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