Check the following and Please Print:
____ Football (Player) 1st_____ 2nd _____3rd _____4th _____ 5th _____6th_____
____ Cheerleader (Player) K______1st_____ 2nd _____3rd _____4th _____ 5th _____6th _____7th_____
____ Football (Coach) Grade to coach: _________
____ Cheerleader (Coach) Grade to coach: _________
Last Name: _________________________ First Name _______________________ Nick Name: _________________ DOB: _______________
Address: ____________________________________________________________ City: _______________________
Home Phone: ________________ Cell Phone: ________________
Parent's Names and Alternate Phone Number: ________________________________________________________________________________
Emergency Contact # and Relationship: _____________________________________________________________________________________
School Attending: _____________________________________________________ Grade attending: __________________________________
Military active/retired: ______ Non-Military: ______ (Please check a box, This will help in attaining funding from FLW in the future) optional..
Email Address: _______________________________________________________________________________________________________
Liability Release
Injury to participants, football players, and/or cheerleaders, in the Waynesville youth Football League (WYFL), may occur from risks inherent to the sport and/or training activities; from placing stress on the body that has not been prepared for; from accidents in learning or practicing playing techniques; from failing to follow game, training, instrutions, safety, or other team rules; from the use of transportation to and from games and other events; and from administration of first aid. Injury can include direct physical and possibly crippling, injury to one's body, and emotional injury experienced as a result of inflicting injury to another or witnessing it. The severity of injury can range from minor cuts, scrapes of muscle strain to catastrophic injury, such as paralysis or even death. In consideration of the WYFL permitting my child or ward to participate in its football and or cheerleading program, I hereby agree on behalf of my child that he or she will assume the risk of injury or death from participating as outlined above. I release the WYFL, the advisory councils, and/or volunteers from any liability resulting from my child's participation in the sport or activity. This assumption of risk and release binds by child's heirs, estate, executor, or administrator, and assigns all members of my family. I have told my child to obey all direction of the coaches/instructors and personnel in charge of the sport or activity and their assistants; to comply with all safety instructions; and to refrain from horseplay and other unsafe practices. Note: By signing this form you also understand that your child's picture my be placed on the WYFL web site.
This release MUST be signed by a parent or legal guardian of the player/cheerleader.
Print Name: ___________________________________________________________
Signature: _____________________________________________________________ Date: ________________________
_______________________________________________________________________________________________________________________________________________________________________________
League Use Only
Date: _______________ League Fee: _______________ Cash: _______________ Check: _______________ Rec'd by: _______________
Birth Certificate: _______________ Physical / Date: _______________/_______________