Nebraska Eight-Man Football Coaches Association
President
Rod Brummels
Osmond High School
Vice President
Bob McEvoy
Clarkson/Leigh High
School
Treasurer
Brian Blevins
Lawrence/Nelson High
School
Secretary
Isaac Frecks
Alma High School
Dear All-Star:
Congratulations to you on your selection. Also, thank you for your cooperation. Without you
there would be no All-Star Game.
Enclosed are several forms, which need be filled out and returned. These forms can be
downloaded on our website at http://nemfca.org/forms.html. The download will allow you to
type in all the information.
1) A personal information form, so that we can contact you or your coach this summer.
2) A program information form. This form asks for information needed for the game
program and also contains the list of signature ads that are obtained. You are
responsible for the collection of at least 10 signature ads @ $40 per ad. Please sell
as many ads as you can. These ads are an important portion of the cost for running
the All-Star game. I have included a copy of a previous program to show what the
signature ads look like.
3) A student participation and parental consent form.
4) An insurance form. Your family policy will be supplemented by a secondary policy.
If you do not have your own insurance, the All-Star Camp Insurance will be the
primary coverage. You, as a player, are covered from the time you leave home until
you return home after the game.
5) We must have a record of a physical examination. A physical taken this year
since January 1 is preferred, but last fall’s football physical form is acceptable.
6) We must also have a graduation picture. Black and white works best, but color is
acceptable.
We need all of these forms, ad money and picture returned by:
Friday, March 11, 2016!
If you have any questions, please contact me.
Respectfully,
Isaac Frecks
NEMFCA Secretary
Alma High School
School: 308-928-2131
Cell: 308-340-0784
E-mail: isaac.frecks@almacardinals.org
**I HAVE INCLUDED A CHECK LIST OF INFORMATION THAT WE NEED,
PLEASE MAKE SURE THAT YOU HAVE ALL FORMS AND ITEMS NEEDED!!
Nebraska Eight-Man Football Coaches Association
All-Star Game Info Checklist
Name:
School:
Item Needed:
Program Info
Signature Ads and Money
Personal Info
Participation/Parental Consent Form
Insurance Information form
Picture
Physical
PLEASE BE SURE YOU HAVE INCLUDED ALL OF THE ABOVE
BEFORE SENDING! PLEASE INCLUDE THIS FORM WITH ALL YOUR
INFORMATION!
Send to:
Alma High School
ATTN: ISAAC FRECKS
PO BOX 170
Alma, NE 68920-0170
If you have any questions please contact me at:
Email:
isaac.frecks@almacardinals.org
School phone:
308-928-2131
Cell phone:
308-340-0784
Fax #:
308-928-2763
All forms are due by:
March 11, 2016
IF WE DO NOT HAVE ALL THE INFORMATION REQUESTED BY THE MARCH 11TH
DEADLINE, WE MAY BE UNABLE TO HOLD YOUR SPOT IN THE GAME!!!!!
Nebraska Eight-Man Football Coaches Association
For All-Star Program
(please type or print)
Player’s Name:
Age:
Height:
Weight:
Position:
Name of School:
Name of Coach:
Future Plans:
(College, Military, Work, etc.)
Signature Ads--Make Checks payable to NEMFCA
($40/Ad--Minimum of 10 Ads)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Please include a billfold size graduation photo! If possible, use black and white.
All forms are due by:
March 11, 2016
IF WE DO NOT HAVE ALL THE INFORMATION REQUESTED BY THE MARCH 11TH
DEADLINE, WE MAY BE UNABLE TO HOLD YOUR SPOT IN THE GAME!!!!!
Nebraska Eight-Man Football Coaches Association
Personal Information Form
(Please type or print)
Player’s Name:
School:
Father’s Name:
Mother’s Name:
How do you want your parents announced at the All-Star Game
(Example: Mr. and Mrs. John Doe or John and Jane Doe)
Home Address:
Phone #:
(
)
-
YOUR shirt size:
Information About your Coach
Coach:
Coaches Home Phone # (
)
-
All forms are due by:
March 11, 2016
IF WE DO NOT HAVE ALL THE INFORMATION REQUESTED BY THE MARCH 11TH
DEADLINE, WE MAY BE UNABLE TO HOLD YOUR SPOT IN THE GAME!!!!!
Nebraska Eight-Man Football Coaches Association
Student Participation and Parental Consent Form
Name of Student:
Name of School Student Represents:
Date:
Date of Birth:
This application is to compete in the 39th Annual Nebraska Eight-Man Football Coaches
Association All-Star Game to be held in Hastings, Nebraska on June 18, 2016. Participation is
entirely voluntary on my part and is made with the understanding that I have not violated any of
the eligibility rules and regulations of the state association, and I agree not to hold the coaches
association, or the acting coaches, or the sponsoring group of the Hastings Area Chamber of
Commerce responsible for any injury accident during practice or participation in this event.
Signature of Student:
I hereby give my consent for the above named student to represent his school in the 39th Annual
Nebraska Eight-Man Football Coaches Association All-Star Game to be held in Hastings,
Nebraska, on June 18, 2016, and all other sponsored activities during this sponsored event. I
authorize the sponsoring group and the coaches in charge to obtain, through a physician of their
choice, any emergency medical care that may become reasonably necessary for the student in the
course of this event. I also agree not to hold the coaches in charge, the coaches association, or
the sponsoring group of the Hastings Area Chamber of Commerce, or anyone acting in their
behalf responsible for any injury occurring to the student named above in the course of this
sponsored activity. I do understand that the financial responsibility for injury or accident to the
student engaged in this activity rests with the parent/guardian.
Signature of Parent/Guardian:
Date:
Phone #: (
Address:
)
-
Note: This form is to be filled out completely and signed by the student and the parent/guardian
and returned to:
Alma High School
ATTN: ISAAC FRECKS
PO BOX 170
Alma, NE 68920
School:
Fax:
308-928-2131
308-928-2763
All forms are due by:
Cell: 308-340-0784
E-Mail: isaac.frecks@almacardinals.org
March 11, 2016
IF WE DO NOT HAVE ALL THE INFORMATION REQUESTED BY THE MARCH 11TH
DEADLINE, WE MAY BE UNABLE TO HOLD YOUR SPOT IN THE GAME!!!!!
Nebraska Eight-Man Football Coaches Association
Insurance Information
Player’s Name:
Parent’s Name:
Phone Numbers in Case of Emergency:
Health Insurance Company:
Policy Number:
Agent’s Name and Address:
Agent’s Phone Number:
All forms are due by:
March 11, 2016
IF WE DO NOT HAVE ALL THE INFORMATION REQUESTED BY THE MARCH 11TH
DEADLINE, WE MAY BE UNABLE TO HOLD YOUR SPOT IN THE GAME!!!!!
All forms are due by:
March 11, 2016
IF WE DO NOT HAVE ALL THE INFORMATION REQUESTED BY THE MARCH 11TH
DEADLINE, WE MAY BE UNABLE TO HOLD YOUR SPOT IN THE GAME!!!!!