2019 Youth Summer Flag Football

* Required Fields
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Fee: $100.00
SPRINGVILLE YOUTH SUMMER FLAG FOOTBALL REGISTRATION FORM

Participant Information
*First Name
*Last Name
*Gender
 Male 
 Female 
*Date of Birth
mm/dd/yyyy
Registration is based on age on May 1st 2019. You may register up an age division but you may not register down.
*What age group are you registering for?
*Shirt Size
You may only request to play on the same team as a sibling. You may request to NOT be on a particular team or with a particular player. While we will attempt to accommodate your request, there are no guarantees.
Special Request
Parent / Guardian 1 Information
*Guardian 1 Name
*Guardian 1 Email
*Best # to be reached
Volunteer - Coach
  
Volunteer - Asst Coach
  
Coaching Experience
Parent / Guardian 2 Information - NOT REQUIRED
Guardian 2 Name
Guardian 2 Email
Best # to be reached
Waiver
Waiver

I/We, the parent(s)/guardian(s) of the above named candidate for a position on the flag football team, hereby give my/our approval to participate in any and all league activities.  I/We assume all the risks and hazards incidental to such participation including transportation to and from the activities.  I/We do hereby waive, release, absolve, indemnify and agree to hold harmless The City of Springville, the organizers, sponsors, supervisors, participants and person(s) transporting my/our child to or from activities, or any claim arising from an injury to my/our child, whether the result of negligence or for any other cause, except to the extent and in the amount covered by accident or liability insurance.  I/We also grant permission to managing personnel or other league representatives to authorize and obtain medical care from any licensed physician, or medical clinic should my child become ill or injured while participating in league activities should I/We not be available.

*Waiver confirmation
 I have read and agree with the waiver. 
The Policy
Refunds can only be issued by the City of Springville.  Refunds must be requested prior to the first scheduled day of practice. All refunds are subject to a 25% administrative fee. Please contact Ashley Lyons for any refund requests.  
Refund Policy
*Refund confirmation
 I have read and understand the refund policy. 
Total Due:
$ 
Important: To receive a confirmation email, please enter your email address here

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