26 NE WolfPack Fall Football & Cheer

Athlete Information

Athlete's Name

First Name Last Name

Birth Date

MonthDayYear

Age As Of July 1st

Gender

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Parent/Guardian Information

Name

First NameLast Name

Home Number

Area CodePhone Number

Cell Number

Area CodePhone Number

E-mail

Emergency Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Area CodePhone Number

Alt. Phone Number

Area CodePhone Number

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe.

Is the athlete prescribed an inhaler? If yes, please explain any instructions.

Selected Team

Requested Jersey # IF AVAILABLE (NOT FOR CHEER)

Medical Release and Authorization

A. Permission to Participate and for Medical Treatment:
I/We, the undersigned, hereby give permission for our child, named above, to participate in football/cheerleading activities in the NE WolfPack Football & Cheerleading programs for the current NE WolfPack season. I/We agree to abide by all the rules and regulations set forth by the team association and the Football League. If any equipment issued to our child should be lost or damaged through our negligence or that of our child, I/We agree to pay to have it replaced. I/We understand that the insurance, which is carried by the team, is secondary to whatever coverage we have. In the event of a claim, I/We agree to submit the claim to our insurance company. If no insurance coverage exists, the insurance coverage provided through the league becomes the primary coverage. I understand that the registration fee is not premium for insurance and that deductibles may apply. In the event of an injury, I/We hereby give permission for our child, named above, to be transported to a nearby emergency medical facility. Additionally, I/We give permission for medical treatment to be administered as deemed necessary by the medical staff.

B. Waiver of Liability:
I/We acknowledge that I am/we are fully aware of the potential dangers of participation in any sport and I fully understand that participation in football, cheerleading and/or dance may result in SERIOUS INJURIES, PARALYSIS, and PERMANENT DISABILITY AND/OR DEATH. Furthermore, I/We fully acknowledge and understand that protective equipment does not prevent all participant injuries, and therefore I/We do hereby waive, release, absolve, indemnify, and agree to hold harmless NE WolfPack Football and cheer, League and the teams that compose the league and their administrators, board members, coaches, volunteers, and any and all organizers, sponsors, supervisors, participants, and persons transporting the above named participant to and from activities, from any claim arising out of any injury to my/our child WHETHER THE RESULT OF NEGLIGENCE OR FOR ANY OTHER CAUSE.

C. Injuries/Assumption of Risk:
I/We acknowledge that injuries may occur in the course of any athletic activity, and I/we hereby specifically assume all risk of any injury occurring during the course of our child’s participation in the Event.

You are aware of covid-19 and you are giving your consent for your child to play

Email

example@example.com

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Payment Methods: Cash/Money Order/Checks/CashApp ($104WolfPack) NO REFUND!!!

PLEASE INCLUDE PLAYERS/CHEERLEADERS NAME, & AGE GROUP FOR ALL CASHAPP PAYMENTS IN SUBJECT LINE!!!!!!

2026 NE WolfPack Fall Football & Cheer