Norton Youth Football Registration Form printable pdf download

OFFICE USE ONLY:

NORTON YOUTH FOOTBALL

 Payment __ CASH _______ Check No.

 Participation agreement

REGISTRATION FORM

2016 Season

 Birth Cert ____New ___ on file

 Physical form



Did you pre‐register online?:

YES

Players full Name: ___________________________________________________________________________

Age by August 1

: _____ Date of Birth: __ __/ __ / _ Grade in Fall:__________

Address: _____________________________________________ Phone #:_________________________

_____________________________________________________ Jersey #’s Pick 3:_____. _____, ______

Father:________________________________________  Check if contact for informational emails

Address if different than player: _______________________________________________________________

Cell Phone #________________________ Father’s email:__________________________________________

Mother:_______________________________________  Check if contact for informational emails

Address if different than player:________________________________________________________________

Cell Phone #________________________ Mother’s email:________________________________________

**** Please Read ****

In consideration of the Norton Youth Football Association, accepting my application of my son or daughter, we the undersigned, intend and agree

to be legally bound hereby and for ourselves, our heirs, executors, and administrators, hereby waive and release any and all rights and claims for

damages we may have against the management of Norton Youth Football, it’s officers, directors, or coaching staff, or any member of any team or

any officer of the Norton Youth football Association, it’s representatives, successors and assigns, its affiliated organizations and sponsors, its

employees and associated personnel, including the owners of the fields and facilities, for any and all injuries to/by me, my son or daughter, at any

practice, scrimmage or game or any other meeting of the Norton Youth Football Association

We in having read the parents consent and waiver hereby agree to obey all the rules and regulations of the Norton Youth Football Association, and

its member’s teams and agree that this right to participate may be revoked at any time for conduct detrimental to the Youth Football as

determined by the Norton Youth Football Association.

Parents Signature: __________________________________________________________________________

The patient and others whose signatures are attached below do hereby consent to any and all medical and surgical treatments including anesthesia

and operations which may be deemed advisable by his or her physicians and surgeons. The intention hereof being to grant authority to administer

and to perform all and singularly any examinations, treatments, anesthetics, operations and diagnostic procedures which may now or during the

course of the patient’s care be deemed advisable or necessary. I also agree that the patient when admitted is to remain in the hospital until his or

her physician recommends the patient’s discharge.

In witness of our consent and agreement to the matters stated in the three preceding sentences, I have subscribed my signature below.

Parent: _______________________________________

Date: _____________________________________

This form is only used by the coach only after every effort is made to contact the parent or guardian and only in case of an

emergency.

Norton Youth Football Registration Form