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!!!!!