Parent Contact Form printable pdf download

2016 Parent Contact Form

Players/Guardian Contact & Release Form

Contact form must be completed and return to New Age Staff prior to participation

Player Info

First Name: ____________________________

Last Name: _________________________

Date of Birth: ___________________________

Age on August

1st: _________________

Grade This Fall: _____________________

Address: _______________________________

City: ____________________

Player T- Shirt Size: (S, M, L, XL)

Is this your child’s first year playing contact football? Yes _______ No _______

Is this your child’s first year Cheering? Yes______ No ______

Parent Info

Best Contact Numbers:

Mobile: _______________________________________

Home: ________________________________

Are you able to receive text messages?

Yes ______

No______

Are you interested in volunteering?

Yes______

No_______

Guardian E-mail Address: _______________________________________

PARENT CONSENT

I, the undersigned parent or legal guardian of the above child, hereby gives my permission for him/her to participate in the New Age Football

Organization. I understand that once the registration fee is paid it is non-refundable. I submit that all information given in this Release/Contact

form is true and accurate. I understand that if false information is submitted, my child shall not be eligible to participate in the Piedmont Youth

Football League, and the registration fee is forfeited.

I agree to read all paperwork communications from New Age throughout the season to ensure my child and I have a positive and enjoyable

experience playing football.

I agree to return all equipment & uniform issued by New Age at the specified date and understand that failure to return will result in legal

penalties and any legal fees associated for equipment return.

I realize football is a contact sport where serious injury may occur, and I release, absolve, indemnify, and hold harmless, New Age Football, it’s

sponsors, agents, directors or officers, or anyone else involved with the PYFL from claims, lawsuits, judgments, etc. I also grant permission for

the NAFO nurse to administer appropriate care (Bandages, Aspirin, Tylenol, Ice, Inhalers if necessary) for the above child that are deemed fit

due to injury. Further, I agree to report all injuries of the above-mentioned player to his Head Coach within 24 hours of their occurrence. I

also understand that representatives of our league may take photos and/or video and may use these images for promotional purpose included,

but not limited to flyers, brochures, ads, and the web.

Parent Printed Name: _________________________________

_________________ .

Parent Signature: ____________________________________

Date:

Parent Contact Form

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