BISON FOOTBALL

     FLB Football Boosters Membership Form

 

 

 

Date: _________________________

 

 

Player: Yes / No                     Player's Grade: _______________

 

Player Name: _____________________________________________________Number: _________________

 

Player Name: _____________________________________________________Number: _________________

 

Parent/Member

Name(s):______________________________________________________________________________

 

Address: _____________________________________________City________________Zip__________

 

Home Phone: ___________________________________ Cell Phone: ____________________________

 

Email Address: ________________________________________________________________________

 

Membership Level: _______________________

Please note: All sizes are adult – please contact Diane Lewis for youth sizes

T-shirt Size:             Sm              Med            Large               X-Large               2X (Please add $2.00)

Sweatshirt Size:      Sm              Med            Large               X-Large               2X (Please add $3.00)

 

Additional T-shirts and Sweatshirts can be ordered with membership

T-shirt Size:            Sm              Med             Large               X-Large               2X (Please add $2.00)

Sweatshirts Size:   Sm              Med             Large               X-Large                2X (Please add $3.00)

 

T-shirt Total: _____ x$9.00 = $__________            Sweatshirt Total: _____x $18.00 = $__________

 

Please make check payable to Ft. LeBoeuf Boosters – Thank You!

 

Contact Diane Lewis 796-4158 for any questions

Mail forms and payment to:

Ft. LeBoeuf Football Boosters
P.O. Box 993
Waterford, PA 16441