Check the following:
____ Football (Player) 1st_____ 2nd _____3rd _____4th _____ 5th _____6th_____
____ Cheerleader (Player) K______1st_____ 2nd _____3rd _____4th _____ 5th _____6th _____7th_____
Last Name: _________________________ First Name _______________________ Nick Name: _________________ DOB: _______________
Address: ____________________________________________________________ City: _______________________
Home Phone: ________________ Cell Phone: ________________ Email: _________________________________________________________
Parent's Names and Alternate Phone Number: ________________________________________________________________________________
Email: _______________________________________________________________________________________________________________
Emergency Contact # and Relationship: _____________________________________________________________________________________
School Attending: _____________________________________________________ Grade attending: __________________________________
Experience (Football and Cheerleading): _____ None (1st year) _____ Some (1-2 years) _____ More than 2 years.
Liability Release
My child has permission to attend the Waynesville Youth Football League (WYFL) mini camp for either football or cheerleading. I understand that it is my responsibility to notify the WFYL camp staff if my child is on any medication or is restricted in any way from participating in any or all activities. In the event of any emergency in which my child requires medical care, I authorize the WYFL camp staff to act for me and obtain whatever medical treatment the staff, in it's best judgment, deems necessary and appropriate. I specifically consent to such treatment including, but not limited to, hospitalization and surgery, and will be responsible for any medical or other financial fees in connection with attendance at the camp. I acknowledge that at the WYFL mini camp, my child will participate in a sport that may involve among other things, physical contact of the body with other persons or objects, including the ground. Therefore, I realize that at the WYFL mini camp my child may incur a risk injury. I specially wave and release the WFYL owners, staff, trustees, board members and camp staff for any claim or damages which I or my child may have for injuries or illness that may be sustained while attending the WYFL mini camp.
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Participants's Medical Plan: _______________________________________________________
Medical plan policy #: ___________________________________________________________
This release MUST be signed by a parent or legal guardian of the player/Cheerleader.
Print Name: __________________________________________________________________
Signature: ____________________________________________________________________ Date: ____________________________________