Youth Registration

2010 EAYF Youth Football Registration Form

(EAYF, Proudly Serving Our Community for over 53 Years)

required field = Required
 
 
Child's last name
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Child's first name
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Child's middle initial
Child's age (in years) required field  

Child's birthdate (format mm/dd/yyyy)

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Child's street address required field
Child's city
required field 		Child's state
required field 		Child's zipcode
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Child's school as of 08/2010
required field 		Child's grade required field
Primary telephone
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Alternate telephone number  
Parent/Guardian email address required field  
For which sport are you registering required field  
DID THE YOUTH PARTICIPATE IN THE ELIZABETHTOWN AREA YOUTH FOOTBALL PROGRAM IN 2009?
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IF YES, WHICH TEAM WAS THE YOUTH ASSIGNED?
ARE THERE SIBLINGS IN THE LEAGUE?

IF SO, WHICH TEAM?  
BRIEFLY INFORM US OF ANY ALLERGY OR MEDICAL CONDITIONS OF THE YOUTH

Special Requests

How did you hear about the EAYF (multiple answers permitted)? required field

I give permission for photographs of my child taken during the EAYF Football season tobe used without compensation for the EAYF Web pages, advertising and/or promotional purposes.
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I understand any equipment assigned to my child is the property of the Elizabethtown Area Youth Football, Inc., and it will be used solely for activities associated with the program. I understand that I am accepting full responsibility for the condition and return of the equipment. I also understand that I will be held responsible for the financial replacement cost of equipment if I fail to return the equipment as described by EAYF.

As the legal guardian of this registrant, I do hereby grant him / her permission to participate in the activities associated with the Elizabethtown Area Youth Football program. I fully understand and agree that in participating in one or more of the programs or using the equipment and/or facilities, there is a possibility of accidental or other physical injury. I agree to the forever release of the EAYF, all league members, coaches, the city of Elizabethtown and/or its employees from all liability, including all acts of active or passive negligence. The Undersigned further expressly agrees that the foregoing Release, Waiver and Indemnity Agreement is intended to be as broad and inclusive as is permitted by law of the Commonwealth of Kentucky and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full force and effect. The Undersigned has read and voluntarily signs the Release and Waiver of Liability and Indemnity Agreement, and further agrees that no oral representations, statements, or inducement apart from the foregoing written agreement have been made.
I agree to the terms listed above required field
Your last name
required field 		Your first name
required field 		Your middle initial
Please choose the current date required field