Late Registration Form
Late Registration Form 7/2/2016
Rising Grade*
(Grade level your player is GOING into and will be in during the season.)
School Name* Sibling in League* (Do you have another player in ZYFL?)
New to ZYFL* Years of Flag Football Experience* (How long has your player been involved in organized flag football?)
Years of Tackle Football Experience*
(How long has your player been involved in organized tackle football?)
Height*
Weight*
(Height and Weight are used for competitive balancing of teams as well as weight restriction rules.)
Jersey Size* Primary Jersey Number Choice* Second Jersey Number Choice* Third Jersey Number Choice*
(Jersey numbers are not guaranteed. The league will attempt to honor requests.)
Please list any player physical conditions, allergies, or medications taken that should be known by the football program staff.
Special Requests/Comments
Medical Release and Authorization I hereby certify that my registrant is in good health and has been cleared by a licensed physician in the last twelve months to participate in all activities inherent in the game of football. In case of injury or emergency, I give my permission for my registrant to be rendered reasonable medical treatment including, but not limited to, treatment at the scene, by EMTs or others and if necessary transportation to a medical facility. I authorize Zionsville Youth Football League (ZYFL) and its directors, agents, coaches and volunteers to take whatever steps necessary to insure the health and safety of my registrant. I have not been given any guarantee as to the results of any examination or treatment.
I, individually, and as a parent or legal guardian of the registrant(s), hereby give my approval for my registrant(s) to participate in all activities of Zionsville Youth Football League (ZYFL) and its affiliations, including Indiana Elementary Football Association (IEFA). I fully understand the risks involved and that it is possible for my child to sustain serious injury or illness during the course of said program which may result in the disability or death of my child. I assume and waive all risks and hazards incidental to such participation, including transportation to and from the activities.
In consideration for the opportunity for my registrant to engage in the aforementioned program, I individually, and as a parent or legal guardian of my registrant, hereby Release and forever Indemnify and agree to hold harmless Zionsville Youth Football League, its Board of Directors and the respective parents, officers, coaches, volunteers and agents (hereinafter collectively known as “Releasees”) from any and all liability to my registrant, his or her other parent or parents, his or her personal representatives, assigns, heirs, estate and next of kin for any and all loss and damage, and any claim or demands therefore on account of injury, illness, disability or death of my registrant, whether caused by simple negligence, gross negligence or willful or wanton conduct of Releasees or otherwise. It is further understood that any participation and involvement in the program may make my child ineligible to participate in school or college athletics. I hereby Release and forever Discharge the Releasees from and against any and all claims, including but not limited to the loss of eligibility to participate in school or collegiate sports, causes of action, or demands relating to or arising out of my child’s involvement in the program.
I further do hereby agree to defend, indemnify and hold harmless said Releasees and their insurers against any and all tort, civil liability, damages, costs, judgments, and/or expenses (including but not limited to legal fees) they may incur as a result of claims made against them as a result of my child’s involvement in the Activity. I HAVE READ THE ABOVE MEDICAL AUTHORIZATION AND FULLY UNDERSTAND ITS CONTENT.
______________________________________________
_________________________
Name
Date
Photo Release and Consent Agreement I grant permission to ZYFL and its subordinates, to use registrant’s name, likeness, images and/or photographs in any print, electronic and/or other media forms, with no obligation to compensate me or registrant for such use. I hereby waive any right to inspect or approve the content of such media, now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of such media. I hereby agree to release, defend and hold harmless ZYFL and its subordinates, including any firm producing or distributing a product in whole or in part, whether print, electronic or other form of media against any claims, damages or liability arising from or related to the use and quality of said product.
My registrant and I agree to abide by the Rules of Zionsville Youth Football League, Inc., including its Code of Conduct, which can be obtained at the ZYFL website or from any ZYFL board member. I attest that all the information I have entered on behalf of my registrant is true and accurate. I understand that falsification of any of the information may render my registrant ineligible for participation in ZYFL activities. Upon request, I will furnish a certified birth certificate for the registrant to any ZYFL board member for determining the registrant’s eligibility.
I HAVE READ THE ABOVE CONSENT AGREEMENT AND FULLY UNDERSTAND ITS CONTENT.
______________________________________________
_________________________
Name
Date
Rising Grade*
(Grade level your player is GOING into and will be in during the season.)
School Name* Sibling in League* (Do you have another player in ZYFL?)
New to ZYFL* Years of Flag Football Experience* (How long has your player been involved in organized flag football?)
Years of Tackle Football Experience*
(How long has your player been involved in organized tackle football?)
Height*
Weight*
(Height and Weight are used for competitive balancing of teams as well as weight restriction rules.)
Jersey Size* Primary Jersey Number Choice* Second Jersey Number Choice* Third Jersey Number Choice*
(Jersey numbers are not guaranteed. The league will attempt to honor requests.)
Please list any player physical conditions, allergies, or medications taken that should be known by the football program staff.
Special Requests/Comments
Medical Release and Authorization I hereby certify that my registrant is in good health and has been cleared by a licensed physician in the last twelve months to participate in all activities inherent in the game of football. In case of injury or emergency, I give my permission for my registrant to be rendered reasonable medical treatment including, but not limited to, treatment at the scene, by EMTs or others and if necessary transportation to a medical facility. I authorize Zionsville Youth Football League (ZYFL) and its directors, agents, coaches and volunteers to take whatever steps necessary to insure the health and safety of my registrant. I have not been given any guarantee as to the results of any examination or treatment.
I, individually, and as a parent or legal guardian of the registrant(s), hereby give my approval for my registrant(s) to participate in all activities of Zionsville Youth Football League (ZYFL) and its affiliations, including Indiana Elementary Football Association (IEFA). I fully understand the risks involved and that it is possible for my child to sustain serious injury or illness during the course of said program which may result in the disability or death of my child. I assume and waive all risks and hazards incidental to such participation, including transportation to and from the activities.
In consideration for the opportunity for my registrant to engage in the aforementioned program, I individually, and as a parent or legal guardian of my registrant, hereby Release and forever Indemnify and agree to hold harmless Zionsville Youth Football League, its Board of Directors and the respective parents, officers, coaches, volunteers and agents (hereinafter collectively known as “Releasees”) from any and all liability to my registrant, his or her other parent or parents, his or her personal representatives, assigns, heirs, estate and next of kin for any and all loss and damage, and any claim or demands therefore on account of injury, illness, disability or death of my registrant, whether caused by simple negligence, gross negligence or willful or wanton conduct of Releasees or otherwise. It is further understood that any participation and involvement in the program may make my child ineligible to participate in school or college athletics. I hereby Release and forever Discharge the Releasees from and against any and all claims, including but not limited to the loss of eligibility to participate in school or collegiate sports, causes of action, or demands relating to or arising out of my child’s involvement in the program.
I further do hereby agree to defend, indemnify and hold harmless said Releasees and their insurers against any and all tort, civil liability, damages, costs, judgments, and/or expenses (including but not limited to legal fees) they may incur as a result of claims made against them as a result of my child’s involvement in the Activity. I HAVE READ THE ABOVE MEDICAL AUTHORIZATION AND FULLY UNDERSTAND ITS CONTENT.
______________________________________________
_________________________
Name
Date
Photo Release and Consent Agreement I grant permission to ZYFL and its subordinates, to use registrant’s name, likeness, images and/or photographs in any print, electronic and/or other media forms, with no obligation to compensate me or registrant for such use. I hereby waive any right to inspect or approve the content of such media, now or in the future, whether that use is known to me or unknown, and I waive any right to royalties or other compensation arising from or related to the use of such media. I hereby agree to release, defend and hold harmless ZYFL and its subordinates, including any firm producing or distributing a product in whole or in part, whether print, electronic or other form of media against any claims, damages or liability arising from or related to the use and quality of said product.
My registrant and I agree to abide by the Rules of Zionsville Youth Football League, Inc., including its Code of Conduct, which can be obtained at the ZYFL website or from any ZYFL board member. I attest that all the information I have entered on behalf of my registrant is true and accurate. I understand that falsification of any of the information may render my registrant ineligible for participation in ZYFL activities. Upon request, I will furnish a certified birth certificate for the registrant to any ZYFL board member for determining the registrant’s eligibility.
I HAVE READ THE ABOVE CONSENT AGREEMENT AND FULLY UNDERSTAND ITS CONTENT.
______________________________________________
_________________________
Name
Date
