ABINGTON YOUTH FOOTBALL/CHEERLEADING

2010 REGISTRATION FORM

(Please fill in all information and print clearly)

Last Name: _________________________ First Name: _________________________

Address: ______________________________________________________________

Phone Number: ___________________________Parents cell#____________________

Email: _____________________________________

Date of Birth: _______________________ Present Age: ________ Weight: __________

Grade and School (as of Sept. 2010) ________________________________________

Family Physician: _______________________________ MD Phone#: ______________

Please list any medical problems or injuries: ___________________________________

REGISTRATION FEE:  $200 one child    $50 each additional child   $125 Mighty Mites Cheer (Fee includes a $25 mandatory Park and Recreation “field maintenance fee”)

***THERE WILL BE A $100 SECURITY DEPOSIT PER FAMILY FOR UNIFORMS.

The check will not be cashed if player’s uniform is returned at the end of football season.

Uniform will not be distributed without security deposit. Check must be dated 12/01/10

Football teams are limited to 50 players per level and Cheerleaders to 34 per level. Registration is based on a first come first serve basis. Football players must submit their application along with a copy of their birth certificate. Application must be filled out completely to qualify. There will be no exceptions to this regulation.  Please note that when the 50-player football maximum has been reached we will not be accepting applications for a wait list.

I, the parent/guardian of the above named child, who is signing up to participate in Abington Youth Football hereby give my consent to his/her participation in any and all of the activities of Abington Youth Football during the coming season. I assume all risks incidental to the conduct of the activities. I do further release, absolve, indemnity and hold harmless Abington Youth Football. For any injury to my child. I hereby waive all claims against the organizers, sponsors and the supervisors, any and all of them, in case of injury to any child, and also absolve and release any person appointed by Abington Youth Football to act as a supervisor and further absolve and release all persons from claims in the transportation of my child to and from any direct or indirect activities. I will also be responsible to return all equipment and/or uniforms issued to my child upon the request of Abington Youth Football. I understand that I will be responsible for payment of any missing equipment and/or uniforms at replacement cost as assessed by Abington Youth Football. I also attest that all information provided above is true and correct to the best of my knowledge. Failure to provide accurate information may lead to the immediate dismissal of your child from the program. I also understand and agree that the registration fee paid is NON-REFUNDABLE for ANY reason. I/We authorize Abington Youth Football to take photographs of my child and to distribute and to post on our website any photographs for Abington Youth Football promotional purposes. I/We authorize Abington Youth Football and Cheerleading staff to apply bug spray as they deem necessary.

Signature of Parent/Guardian______________________________ Date_________________

During the season there are approximately four home Varsity games as well as 4 home Junior Varsity games. As parents it is your obligation to volunteer in some manner throughout the season, because as you know a program is only as successful as the parents who support it. Therefore, it is your duty to volunteer at least one hour during the season. Attached is a list of positions that need to be filled. You are required to check off at least one. You will be assigned a game and time that you must volunteer. If for any reason you cannot fulfill the date given to you, it will be your responsibility to get coverage for that game.

· Snack shack _____

· Gate 50/50   _____

· Announcer _____

· Spotter _______

· Chains _______

· Post game clean-up _______

· Barrett’s Haunted Mansion ________

· Apparel ________

Name:________________________

Phone________________________

Email_________________________

You will be contacted prior to the first game of the season.

Thank you,

AYF