Sandston Jets Football & Cheerleading Youth Association

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2017 Football and Cheering Registration

* Registration:

Football

Cheering

PARTICIPANT INFORMATION

* Last Name:

* First Name:

* DOB (MM/DD/YYYY):

* Age on 9/30/2017:

DMV ID or Passport #::

* Community/County of Residence:

* School:

* Height (Feet/Inches):

* Weight (Pounds):

* Previous Experience:

* Total Seasons Played/Cheered:

PARENT/GUARDIAN #1 INFORMATION

* Last Name:

* First Name:

* Relationship to Participant:

* Cell Phone (###-###-####):

* Alternate Phone (###-###-####):

* Street Address:

* City:

* Zip Code:

* Email:

PARENT/GUARDIAN #2 INFORMATION

Last Name:

First Name:

Relationship to Participant:

Cell Phone (###-###-####):

Alternate (###-###-####):

Street Address:

City:

Zip Code:

Email:

EMERGENCY MEDICAL RELEASE AND AUTHORIZATION

Please list any allergies, medications, physical, psychological or emotional conditions that might affect your child's participation:

By checking this box I acknowledge that participation in football/cheering can result in serious injuries to my child and that protective equipment does not prevent all injuries. *

By checking this box I hereby authorize my child's physician or another physician to render treatment to my participant.

By checking this box I hereby authorize for my child to be transported by ambulance or emergency vehicle to the nearest emergency facility in my absence.

PLEASE READ THE FOLLOWING ACKNOWLEDGEMENTS BELOW

1. I understand that registration fees are NON-REFUNDABLE.
2. A returned check fee of $30.00 will be charged for all checks returned for insufficient funds. Failure to remit fees, payments or money owed will result in SJFCYA pursuing other collection procedures including legal action.
3. I understand that my child will not be rostered with the MYFL until all registration fees are paid in full. I further understand that I will be required to pay any add-on fees as required by the MYFL as necessary.
4. I do hereby consent for my child to participate in all activities of the Sandston Jets.
5. I understand that I must provide a DMV child’s ID card for my child to participate regardless if he/she was registered at SJFCYA or any other association in 2017, I further understand that football participants ID’s will not be returned until the conclusion of the season.
6. To the best of my knowledge, the enrolled participant is in good physical and emotional health.
7. I understand the participation with SJFCYA and MYFL is a privilege, not a right and any action deemed detrimental to SJFCYA can result in disciplinary action including but not limited to removal from SJFCYA.
8. I assume all risks incidental to such participation, including transportation to and from such activities. I hereby, waive, release, absolve, indemnify, and hold harmless the SJFCYA, its organizers, sponsors, supervisors, coaches, participants, and any other persons who transport my child to and from activities for any claim or cause, whether the result of negligence or for any other cause except to the extent and in the amount covered by accidental or liability insurance.
9. I understand that I am responsible for picking up my child from all activities, games and practices on time.
10. I understand that concession work and/or chain crew is required of me. If I do not fulfill this duty when assigned my child may not be allowed to participate.
11. I understand there is a mandatory fundraiser for each participant. I further understand that each participant may opt out of the fundraiser by paying the $40.00 opt-out fee due at time of registration.
12. I understand that there is no guarantee of equal playing time. Under the MYFL Constitution each player will have a minimum of six (6) plays, which include special teams.
13. I agree to return all uniform/equipment issued by SJFCYA to my child in the same condition as when received outside of normal wear. If not returned or damaged I agree to pay replacement costs for the uniform/equipment. I understand that if replacement cost is not paid other collection procedures including legal action will be pursued as determined by the SJFCYA and I will be responsible for all legal costs.
14. I understand that once my child has registered with SJFCYA for the 2017 season, the child, under MYFL rule, may not register with another MYFL member association for the 2017 season.
15. I understand that my child will be placed on the team that best suits his age, weight and skill level within the guidelines set by MYFL solely determined by the Association and Coaches.
16. SJFCYA will periodically display pictures of the football players and cheerleaders on its website. Please check the appropriate statement:

* :

I will allow my child's picture to be displayed.

I will not allow my child's picture to be displayed.

By checking this box I acknowledge that I have read, understand and will abide by all the acknowledgements stated above. *

* Date:

ONLINE REGISTRATION FEE SCALE:

Early Registration

* April 16 - May 31: Football $110 + $5 Online Processing Fee, Cheering $140 + $5 Online Processing Fee and Pep Squad $100 + $5 Online Processing Fee (NO MULTI-CHILD DISCOUNT AND EARLY REGISTRATION FEES MUST BE PAID IN FULL AT TIME OF REGISTRATION)

Regular Registration Fee

* June 1 - August: Football $130 + $5 Online Processing Fee, Cheering $140 + $5 Online Processing Fee and Pep Squad $100 + $5 Online Processing Fee. ($10 DISCOUNT FOR EACH ADDITIONAL SIBLING REGISTRATION)

FEES INCLUDE, BUT ARE NOT LIMITED TO:
Football (*game jersey, *game pant, *helmet, *shoulder pads, *game socks, *chin strap and mouthpiece)

Cheering (*uniform top, *uniform skirt, uniform socks, lollies, shoes and middie; warm-up suit NOT included)

*MUST BE RETURNED AT THE END OF SEASON

LEAGUE USE ONLY

Amount Paid: _______________ Date: _______________

Amount Paid: _______________ Date: _______________

Check# __________ /__________ Cash __________ /__________

Credit/Debit Card __________ /__________

Received By: __________ / __________

Receipt # __________ / __________

Fundraiser Opt Out: Amt. __________ Date __________ By __________

ISSUED (FOOTBALL):

Jersey (Size/#):____________________

Pants (Size):_______________________
Helmet (#):________________________
Shoulder Pads (#):__________________

ISSUED (CHEERING):

Top: _____________________________

Skirt: ____________________________

Warm Up Jacket: ___________________

Warm Up Pants: ____________________

RETURNED:

_________________________________

_________________________________

_________________________________

_________________________________

Signature:

Date:

* indicates required fields

IMPORTANT: Online Payment with credit cards is not active for this form

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2017 Football and Cheering Registration