Hamilton Bulldogs 

Football

HAMILTON YOUTH ATHLETIC ASSOCIATION

Last Name First Name

Age    Birthday (mm/dd/yy) 

Street Address 

City    State    Zip 

Disability

Home Telephone #    Emergency # 

E-mail Address 

Parents Names

Father    Mother 

Guardian Name 

Parent/Guardian Signature 

By clicking this box and entering my name below, I agree to all of the terms above.

This organization will consist of all Butler County area children and is uniquely tailored to meet the

needs of children who have cognitive or physical disabilities.  We have many children with Down

Syndrome, Autism and a variety of other syndromes.  We also have children who use walkers and

some who are visually impaired.  We try our best to accommodate all children with a desire to

play.  If there is a doubt as to whether your child can (and should) play with us, please contact us!

We also ask that our player be at lleast 6 years of age but many continue until the age of 25.

A $35.00 fee is due upon sign-up.  Each player will receive a T-shirt.  If you wish to purchase

additional shirts they will cost $8.00.

Shirt Size

Please bring registration  fees to the field house Monday through Thursday from 6 to 8 pm

or send to:

Hamilton Youth Athletics Association

c/o Ken Beaman

5523 Dubonnett Drive

Fairfield, OH 45014