Madison Academy Youth Football
2026 Fall Season Registration
Player Name
*
First Name
Last Name
Player’s Date of Birth
*
-
Month
-
Day
Year
Date
Player’s Age
*
What school does the player attend?
*
What grade is the player in?
*
Please Select
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
(Grade currently in)
Has the player participated in football before?
*
Yes
No
If yes, where did they play football at?
*
Madison Academy Youth Football
Other
If other, where did they play at?
If yes, what positions did they play?
What size t-shirt does the player wear?
*
Please Select
Youth XS
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Player’s Height
*
Height in inches
Player’s Weight
*
Weight in lbs
Please list your player’s top 3 choices for their jersey number.
*
Important Information
Does the player have any allergies?
*
Please Select
Yes
No
If yes, please list all allergies. If no, please type “none.”
*
Parent/Guardian’s Name
*
First Name
Last Name
Parent/Guardian’s Email Address
*
example@example.com
Secondary Email Address
example@example.com
Parent/Guardian’s Main Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian’s Secondary Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Information
Emergency Contact’s Name
*
First Name
Last Name
Relationship to Player:
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Are you interested in being a coach?
*
Please Select
Yes
No
Maybe - I would like more information
Are you interested in being a team mom?
*
Please Select
Yes
No
Maybe - I would like more information
If there is any important information your coach needs to know regarding your player, please enter in the comment section below.
*
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Flag Football Registration: age minimum is 4. Cannot turn 7 Before July 1
$125.00
$
125.00
8U Division: cannot turn 9 Before July 1
$225.00
$
225.00
10U Division: cannot turn 11 Before July 1
$225.00
$
225.00
11U Division: cannot turn 12 Before July 1
$225.00
$
225.00
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
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