attention youth football players and parents
ATTENTION YOUTH FOOTBALL PLAYERS AND PARENTS
Connersville Youth Football registration for the 2015 fall season Players may pick up & drop off registration at Athletic Arena & Mancinos in Connersville BEFORE August 3rd. The cost is $80.00 per player. For parents/guardians with more than one participant the cost is $80.00 for the first player, $40.00 for each additional player. This cost covers equipment rental for the season as well as insurance for each participant during any team activity. There will be no gate fee for home games. Youth Football teams will be divided by grade level 1st-6th. Each grade level will have its own team.
Anyone with concerns about cost, contact Coach Kelly @ 913-522-6555 or email…[email protected] Every coach must fill out a coaches application for the 2015 season including returning coaches
PLACE THIS REGISTRATION FORM in a SEALED ENVELOPE with CASH or CHECK (made payable to Connersville Youth Football) & players NAME & GRADE on the OUTSIDE of envelope & return it to Athletic Arena, Mancinos, or Mail it to: Attn: Coach Kelly @Connersville High School, 1100 Spartan Dr. Connersville, IN 47331
FIRST YEAR PLAYERS MUST ALSO PROVIDE A COPY OF THEIR BIRTH CERTIFICATE CONNERSVILLE YOUTH FOOTBALL 2015 YOUTH LEAGUE SIGN-UP AND WAIVER FORM PLAYERS NAME____________________________Parent/Guardian______________________________ BIRTH DATE_______________________________ AGE (AS OF 09/01/15) _______________________ ADDRESS______________________________________________________________________________________ PHONE______________________________ EMERGENCY CONTACT NUMBER_________________________ EMAIL_________________________________________________________________________________________ PLAYERS GRADE IN THE FALL OF 2015__________________________________________________ BROTHERS/SISTERS PARTICIPATING THIS YEAR? Y/ N NAME________________________________________ GRADE______________ Payment Method: Select One: Full With Raffle____________
$20.00 Installments___________ Need Scholarship_________
Equipment hand-out and weigh in will be Sat July 18th and 25th 8:00 a.m. – 12:00 p.m. **You can turn in registration and payment during this time if needed. ** Raffle Tickets can be picked up throughout the summer at the
Waiver of Responsibility I hereby give my permission for the above named child to participate in Connersville Youth Football. I understand that Connersville Youth Football will not be held responsible for any injuries or sickness during the actual game, before or after the game, while on Fayette County School Corporation or any Connersville Youth Football facilities properties or during practice sessions. I release the Fayette County School Corporation, Connersville Athletic Department, and CHS football staff of all liabilities. Parent Signature ________________________________________ Date _______________
To be completed by league representative only Initials_____Today’s date_________ Amount paid_________Check number__________ Cash______
Connersville Youth Football registration for the 2015 fall season Players may pick up & drop off registration at Athletic Arena & Mancinos in Connersville BEFORE August 3rd. The cost is $80.00 per player. For parents/guardians with more than one participant the cost is $80.00 for the first player, $40.00 for each additional player. This cost covers equipment rental for the season as well as insurance for each participant during any team activity. There will be no gate fee for home games. Youth Football teams will be divided by grade level 1st-6th. Each grade level will have its own team.
Anyone with concerns about cost, contact Coach Kelly @ 913-522-6555 or email…[email protected] Every coach must fill out a coaches application for the 2015 season including returning coaches
PLACE THIS REGISTRATION FORM in a SEALED ENVELOPE with CASH or CHECK (made payable to Connersville Youth Football) & players NAME & GRADE on the OUTSIDE of envelope & return it to Athletic Arena, Mancinos, or Mail it to: Attn: Coach Kelly @Connersville High School, 1100 Spartan Dr. Connersville, IN 47331
FIRST YEAR PLAYERS MUST ALSO PROVIDE A COPY OF THEIR BIRTH CERTIFICATE CONNERSVILLE YOUTH FOOTBALL 2015 YOUTH LEAGUE SIGN-UP AND WAIVER FORM PLAYERS NAME____________________________Parent/Guardian______________________________ BIRTH DATE_______________________________ AGE (AS OF 09/01/15) _______________________ ADDRESS______________________________________________________________________________________ PHONE______________________________ EMERGENCY CONTACT NUMBER_________________________ EMAIL_________________________________________________________________________________________ PLAYERS GRADE IN THE FALL OF 2015__________________________________________________ BROTHERS/SISTERS PARTICIPATING THIS YEAR? Y/ N NAME________________________________________ GRADE______________ Payment Method: Select One: Full With Raffle____________
$20.00 Installments___________ Need Scholarship_________
Equipment hand-out and weigh in will be Sat July 18th and 25th 8:00 a.m. – 12:00 p.m. **You can turn in registration and payment during this time if needed. ** Raffle Tickets can be picked up throughout the summer at the
Waiver of Responsibility I hereby give my permission for the above named child to participate in Connersville Youth Football. I understand that Connersville Youth Football will not be held responsible for any injuries or sickness during the actual game, before or after the game, while on Fayette County School Corporation or any Connersville Youth Football facilities properties or during practice sessions. I release the Fayette County School Corporation, Connersville Athletic Department, and CHS football staff of all liabilities. Parent Signature ________________________________________ Date _______________
To be completed by league representative only Initials_____Today’s date_________ Amount paid_________Check number__________ Cash______
