Powder Puff Football Information

(Please print)

Name: ________________________________________ Grade: _____

Phone Number: _______________________

Parent/ Guardian Name: __________________________________

Number: ______________________

Allergies, special medical attention needed (asthma, etc.)

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First Period Teacher: ________________________

T-Shirt Size (Circle One): S M L XL

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Parent Release:

My child, ___________________________, has my permission to participate in the

Powder Puff Football game to take place Thursday, November 18th, 2010 at Richard
Montgomery High School.

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Parent/ Guardian Signature Date