BOERNE YOUTH FOOTBALL LEAGUE REGISTRATION FORM. Parent/Guardian 1 Information (this address is expected to be the same as the participant s):

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1 BOERNE YOUTH FOOTBALL LEAGUE REGISTRATION FORM Parent/Guardian 1 Information (this address is expected to be the same as the participant s): Last Name: Street Address: First Name: City: State: ZIP: Phone (H): Phone (W): Phone (M): MYF will communicate with parents via the website and . It is important that you provide all addresses you would like to be contacted at and that you set any spam filters on your home computer to accept s from Boerneyouthfootball.org or leagueathletics.com (our web host). Parent/Guardian 2 Information (if address is same as other parent, leave address info blank): Last Name: Street Address: First Name: City: State: ZIP: Phone (H): Phone (W): Phone (M): (1 or Many) BYFA will communicate with parents via the website and . It is important that you provide all addresses you would like to be contacted at and that you set any spam filters on your home computer to accept s from Boerneyouthfootball.org or leagueathletics.com (our web host). Basic Participant (child) Information: Last Name: First Name: Address Indicate 1: Same as Parent/Guardian 1 Same as Parent/Guardian 2 Sex: M F Date of Birth: Age on July 31, 2016: Weight: Known medical conditions and medications (only list those that are important to your child s coaches): Emergency Contact Information3- Minimum of 2 required; 3You may indicate if it is the same as a parent/guardian above by entering Parent 1 or Parent 2 in the Full Name field; Full Name: Relationship: 1 2 Home Phone: Work Phone: Mobile Phone: (Primary): Full Name: (Secondary): Relationship: Home Phone: Work Phone: Mobile Phone: (Primary): (Secondary): Other Information Current School: Expected High School: Prior seasons of football experience: Prior Position(s): Last Coach: Last Team: Last Weight Class: Preferred League Volunteer Activity Select one or more options Head Coach Assistant Coach Marketing Fundraising Team Parent Concessions WC Please refer to our website ( for detailed information regarding optional equipment purchases available, refund policies, age/weight matrix, calendar of events, and much more!

2 BOERNE YOUTH FOOTBALL REGISTRATION FORM (Page 2) Agreement By signing below, the parent or guardian certifies that they have read and agree to the following: 1. I certify that I am a legal parent or guardian of the above named participant. 2. I grant permission to my child or ward to play Boerne Youth Football and assume all risks and hazards incidental to Football participation, including transportation to and from activities. 3. I agree to perform volunteer duties for the league as identified above. 4. I agree to support (i.e. volunteering, cheering, and showing good sportsmanship) my child s team, including his/her Coaches, the Team Parent, other players, and other player s parents. 5. I grant permission to Boerne Youth Football officials to consent to emergency treatment for my child until a legal guardian can be contacted. 6. I understand Boerne Youth Football does not carry accident insurance. 7. I agree to be notified of any parent/guardian meetings electronically. 8. I agree to return all equipment issued by Boerne Youth Football at the end of the season, or at the end of my child s participation, whichever occurs first, and to pay the replacement cost for any equipment not returned. 9. I agree to abide by the CTYFL Code of Conduct. Parent or Guardian Signature: Date Signed:

3 CTYFL Sports Physical Form Name: Gender: M F Date of Birth: / / Father s / Guardian s Name: Contact Number: Mother s / Guardian s Name: Contact Number: Address: City: State: Zip Code: Home Phone: Alternate Emergency Contact: Daytime Phone: MEDICAL ALERTS (Allergic Reactions, Contact Lenses, etc.): Medical History: Parents: This health record is a critical element in the determination of an athlete s risk of injury in sports. Please read and answer all the questions before seeing a physician for the athlete s physical examination. 1) Has anyone in the athlete s family (grandparents, mother, father, brother, sister, aunt, YES NO Don t Know uncle) died suddenly before age 50? 2) Has the athlete ever stopped exercising because of dizziness or passed out during exercise? 3) Does the athlete have asthma (wheezing), hay fever, or coughing spells after exercise? 4) Has the athlete ever had a broken bone, had to wear a cast, or had an injury to any joint? 5) Does the athlete have a history of concussion or head injury? 6) Has the athlete ever suffered a heat-related illness (heat exhaustion / heat stroke)? 7) Does the athlete have a chronic illness or see a doctor regularly for any particular problem? 8) Does the athlete take any medication(s)? 9) Is the athlete allergic to any medications or bee stings? 10) Does the athlete have only one of any paired organs? (eyes, ears, kidneys, testicles, ovaries) 11) Has the athlete had an injury in the last year that caused the athlete to miss 3 or more consecutive days of practice or competition? 12) Has the athlete had surgery or been hospitalized in the past year? 13) Has the athlete missed more than 5 consecutive days of participation in usual activities because of illness, or has the athlete had a medical illness diagnosed that has not been resolved in the past year? 14) Are you, the athlete, worried about any problem or condition at this time? Please give details on any YES answer from the above health history:

4 CTYFL Sports Physical Form PHYSICAL EXAMINATION FORM Height: Vision: Right Left Weight: Uncorrected: / / Pulse: Corrected: / / Blood Pressure: 1) Eyes 2) Ears, Nose, Throat 3) Mouth and Teeth 4) Neck 5) Cardiovascular 6) Chest and Lungs 7) Abdomen 8) Skin 9) Genitalia / Hernia (Male) 10) Musculoskeletal a) Neck b) Spine c) Shoulders d) Arms / Hands e) Hips f) Thighs g) Knees h) Ankles i) Feet 11) Neuromuscular Normal Abnormal Findings Initials Please Print / Stamp This Form must be signed by a licensed physician, physician s assistant or nurse practitioner. Examiner s Name: Street Address: City, State, Zip Telephone: I certify that I have examined this athlete and found him/her medically qualified to participate in sports. I also certify that I am a licensed medial physician, physician s assistant, or family nurse practitioner. Examiner s Signature: Date: Participation Restrictions:

5 CTYFL WAIVER OF LIABILITY, MEDICAL RELEASE AND INDEMNIFICATION AGREEMENT I/We hereby voluntarily permit my/our child/ward to participate in the Central Texas Youth Football League (hereafter referred to as CTYFL ). I/we acknowledge that CTYFL is comprised of several independent Associations and all references to CTYFL will include each and every Association within CTYFL as well as the League itself. Name of Child: Child s Doctor: Phone: ( ) - Existing Medical Coverage: Current Medications: I/WE UNDERSTAND AND FULLY ACCEPT THAT THERE ARE RISKS INVOLVED IN SPORTS, AND THAT ACCIDENTS AND INJURIES ARE COMMON AND ARE ORDINARY OCCURRENCES OF SPORTS. I/WE HEREBY AGREE TO ACCEPT ANY AND ALL RISKS OF INJURY OR DEATH, AND VERYIFY THIS STATEMENT BY PLACING MY/OUR INITIALS HERE. (INITIAL HERE) As consideration for being permitted by CTYFL to participate in these activities, I/we hereby release and hold harmless the CTYFL board, volunteers, designated coaches, & program officials from all liability, and from all actions or claims that I/we or my/our child now or hereafter have for damage or injury to my/our child, or to any person or property, resulting from the negligence or other acts of any employees or volunteers in connection with my/our child s participation. I/We further agree that this waiver, release and assumption of risks are to be binding on the heirs and assigns of the undersigned. I/We further agree to indemnify and to hold CTYFL, its board members, officers, volunteers & affiliates free and harmless from any loss, liability, damage, cost or expense which may incur as a result of any injury and/or property damage that I/we or my/our child may cause or sustain while participating in this activity. In case of a medical emergency, I/we hereby give permission to CTYFL Board & Volunteers to order treatment for my/our child, including any necessary medical treatment and/or diagnostic procedures. I/We also hereby give permission to CTYFL Board & Volunteers to disclose the information contained on this form to medical personnel. I/We understand that an attempt will be made to reach me/us by phone immediately. I/We agree to pay all medical, hospital, or other expenses, which my/our child or I/we may incur as a result of such treatment. CTYFL does not disclose any nonpublic personal medical information, except as required or permitted by law. CTYFL also does not provide any medical or other insurance protection or benefits for those who use recreational equipment or engage in activities on any public or private property except for participants covered by CTYFL and then only during participation in a sanctioned CTYFL event. I/WE HAVE CAREFULLY READ THIS RELEASE AND FULLY UNDERSTAND ITS CONTENTS. Printed Name of Parent/Guardian Parent/Guardian Signature Date Printed Name of Parent/Guardian Parent/Guardian Signature Date

6 Policy Governing Spectator Behavior at CTYFL Events Please read and understand the following CTYFL Spectator Behavior Policy. After reading, each parent or guardian will sign and date this form at the bottom acknowledging you are aware of and accept the CTYFL Spectator Behavior Policy and will accept and abide by the consequences outlined in the CTYFL Bylaws and Procedures Manual for violation of this policy. Parents/guardians and their friends are responsible for the behavior and actions of their children as well. 1) Spectators are expected and encouraged to enthusiastically cheer for and encourage the players on their team. Being allowed to observe your child s efforts on the field is a privilege, not an opportunity to verbally assault others or be generally obnoxious. If the other team s spectators are breaking the rules you should report them to the Field Director or League Officer you must never choose to act in the same manner. You would not allow this of your children and they should be able to expect that you will not embarrass them with immature behavior. 2) Respect and obey the rules of the hosting Association. Treat their field as you would your home field. All CTYFL facilities prohibit the use or consumption of alcohol, tobacco products or any controlled substance at that facility. 3) Respect the decisions of the coaches. Remember that this is a game for and played by children not professional athletes. 4) Respect the other team and respect the other people around you. Profane and harassing language is absolutely forbidden at all CTYFL events. As parents they are as proud of and concerned for their children as you are with yours. Do not belittle the players of the other team unless you are ok with someone belittling your children in front of you and if you are ok with that you need to reconsider your priorities. 5) Respect the integrity and efforts of the Game Officials. They are on the field because they have made a commitment to learn, understand and interpret the rules of the game. CTYFL uses only officials in good standing with the Texas Association of Sports Officials (TASO). While that does not guarantee they will make perfect decisions in every single situation, it does guarantee they have received the training necessary to understand what that perfect decision should have been. 6) Be objective and accept the possibility that it was simply a greater effort by the opponents rather than cheating that allowed them to make a good play. 7) Cheating and bad sportsmanship are not options. They rob victory of meaning and replace the high ideals of sport with the petty values of a win -at-all-costs mentality. Victories attained in dishonorable ways are hollow and degrade the concept of sport. 8) Spectators, by definition, are not to be in the Field Area and as such they will normally be subject to disciplinary actions taken by the Field Directors. However, their negative or offensive comments directed at officials, players or coaches may lead to their team and Head Coach receiving an Unsportsmanlike Conduct Foul from the officials for each offense. Any CTYFL Head Coach, Assistant or Spectator receiving two (2) Unsportsmanlike Conduct Fouls is immediately ejected from the game. All Unsportsmanlike Conduct fouls accrued by that team s sideline, whether actually on the Head Coach, his Assistants or his Spectators will be attributed to the Head Coach as well as the person committing the foul. Name of Player / Cheerleader Parent/Guardian #1 Signature Print Your Name Date Parent/Guardian #2 Signature Print Your Name Date

7 CTYFL Age Waiver Request Date: To Whom It May Concern: I/We,, parents(s)/guardian(s) of, request that he/she be allowed to play in the division which is one age division older than he/she is currently qualified for by age. I/We understand that this will mean he/she will possibly be playing with and against children who are older, more mature, larger and more developed than my child. As such, I/We accept that he/she may be put at a physical disadvantage and that the risk of injury has increased beyond even the normal risks of participating in a contact sport such as football. I/We fully accept the consequences of this decision and hold harmless Central Texas Youth Football League (CTYFL), all officers of CTYFL, (participating association) and all officers of for any injuries sustained by while participating in CTYFL activities. Signature Print Name Signature Print Name

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