2024 Player Registration Spring Flag Football

Email*

example@example.com

List the name of the parent/guardian completing this registration.*

First NameLast Name

Parent/Guardian Phone Number*

Please enter a valid phone number.

List the athletes first and last name*

First NameLast Name

Athlete’s Age as of May 1, 2024*

Athlete’s Birth Date*

Athlete's Age as of May 1 , 2024. Please upload players birth certificate below. *

League Athlete is in:*

D Division (Ages 6-7)C Division (Ages 8-9)B Division (Ages 10-11)A Division (Ages 12-14)

T-shirt size*

If athlete has a parent that is interested in coaching, please list name below. Coaches need to hard copies of two clearances by March 19th meeting.

First NameLast Name

School athlete attends*

Athlete's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Offensive Position*

QuarterbackWide Receiver/Tight EndRunning BackOffensive Line

Defensive Position*

CornerbackSafetyLinebackerDefensive Line

Athlete will registering*

With a TeamAs an individual. Please place me on a team.

If athlete is registering with team, please list organization and coach.

Which statement best describes your athlete?*

My athlete has never played flag or tackle football.My athlete has played both flag and tackle football.My athlete has played flag, but not tackle football.My athlete has not played flag, but has played tackle football.

Please select one of the following below.*

Along with flag football information I want to be notified about additional NEPA Youth Football programs (Speed/Strength Sessions, Football Skill Development/ Camps).I am not interested at this time.

Medical and Promotional Wavier (Please Read and Sign Below)

I acknowledge that I, individually, have voluntarily applied (for my child) to participate in NEPA Youth Football (NEPAYF), Progressive Speed and Strength Training (PST) Sandlot Baseball Academy (SBA).  I acknowledge the risks and the potential risks of athletic training and participating in workouts, sessions or camps with NEPA Youth Football, Progressive Speed and Strength Training and/or Sandlot Baseball Academy. However, I feel that the possible benefits to me and my child are greater than the risk assumed.

I am aware that although NEPA Youth Football, Progressive Speed and Strength Training and/or Sandlot Baseball Academy and its owners, and authorized agents make reasonable efforts to make each athlete’s training a safe and productive experience, that there are inherent risks which occur as a result of such physical activity.

I acknowledge that an athlete, when training, through no fault of his own, his trainer(s), or the facility, may become injured for a variety of reasons that are unavoidable.

I represent that I or my child is in good health and suffers from no physical impairment, which would limit my use of NEPA Youth Football, Progressive Speed and Strength Training and/or Sandlot Baseball Academy instruction.  I further represent that I carry full and complete medical insurance coverage.  I acknowledge that NEPA Youth Football, Progressive Speed and Strength Training and/or Sandlot Baseball Academy have not and will not render any medical services including medical diagnosis of my physical condition.
In consideration of being permitted by NEPA Youth Football, Progressive Speed and Strength Training and/or Sandlot Baseball Academy to participate in its training program and to use its facilities,  I hereby, intending to be legally bound for myself, my heirs and assigns, executors or administrators and/or guardians of my son/my daughter/my ward specifically agree that NEPA Youth Football, Progressive Speed and Strength Training and/or Sandlot Baseball Academy and its owners and agents shall not be liable for any claim, demand, cause of action of any kind whatsoever for, or on account of death, personal injury, property damage or loss of any kind resulting from or related to my use of the facilities or participation in any athletic training, exercise or activity within or outside club premises, and I agree to hold NEPA Youth Football, Progressive Speed and Strength Training and/or Sandlot Baseball Academy and its owners harmless from same.  I hereby waive any and all claims for any and all injuries I may suffer under any circumstances, including but not limited to those claims arising from the negligence of NEPA Youth Football, Progressive Speed and Strength Training and/or Sandlot Baseball Academy, its employees, agents, servants, invitees, co-members, contractors or sub contractors, employees or otherwise.


Promotional Release
In additional consideration of being permitted by NEPA Youth Football, Progressive Speed and Strength Training and Sandlot Baseball Academy to participate in its training program and to use its facilities, I hereby permit NEPA Youth Football, Progressive Speed and Strength Training and Sandlot Baseball Academy to use my name, image and likeness for promotional purposes limited to its athletic training programs and facilities.  NEPA Youth Football, Progressive Speed and Strength Training’s and Sandlot Baseball Academy promotional mediums include but are not limited to print, radio, video, television, and the Internet.

I acknowledge that I have read this release and waiver and fully understood its contents.  I have been fully and completely advised of the potential dangers incidental to engaging in the activity and instruction of the athlete training and I am fully aware of the legal consequences of agreeing/signing the release.  I voluntarily agree to the terms and conditions stated above.

Medical and Promotional Wavier Signature*

Covid-19 Release and Wavier (Please Read and Sign Below)

RELEASE AND WAIVER OF LIABILITY AND ASSUMPTION OF RISK FOR  PARTICIPATION IN NEPA YOUTH FOOTBALL AND PROGRESSIVE SPEED AND STRENGTH TRAINING PROGRAMS  
 The Centers for Disease Control and Prevention declared a global pandemic due to the  Novel Coronavirus (COVID-19). In consideration for my son/daughter participating in programs with NEPA Youth Football (NEPAYF)/Progressive Speed and Strength Training (PST) I, the undersigned (if you are not 18 years old, your  parent or legal guardian must sign), individually and collectively referred to below in the first  person agree to be bound by each of the following as my voluntary act:  
 A. Voluntary Participation. I understand and confirm that my participation in this  activity is voluntary. If I choose not to participate, the coaches/trainers and/orNEPA Youth Football (NEPAYF)/Progressive Speed and Strength Training, its administrators or employees will understand and there will be no repercussions based  on your desire to protect yourself or your child. This is strictly a voluntary participation.  
 B. Identification of Risks. Before, during, after, and traveling to and from training events, I understand I might be exposed to COVID-19 which can cause severe respiratory  distress, hospitalization, permanent disability and death. Symptoms include, but are not limited  to, fever, coughing, and shortness of breath. I understand my participation may involve risk of  injury, loss, and death. I understand that this Waiver and Release of Liability and Assumption of  Risk Agreement is intended to address all of the risk of any kind associated with my participation  in any respect, including, particularly, such risks created by actions, inactions or negligence on the part of the NEPA Youth Football (NEPAYF)/Progressive Speed and Strength Training, its agents, employees, volunteers, or assigns.  
 C. Health and Safety Precautions. During the training events, I will abide by all rules  and guidelines imposed by the NEPA Youth Football (NEPAYF)/Progressive Speed and Strength Training, including but not limited to, temperature checks, face masks, mandatory seating arrangements, social distancing, and  mandatory disinfecting or handwashing. I understand that refusal to abide by these rules may result in discipline, up to and including being sent home immediately from workouts. However, whether or not the NEPA Youth Football (NEPAYF)/Progressive Speed and Strength Training imposes these measures has no bearing on my assumption of risk, waiver or indemnification as described below.  
 D. Assumption of Risk. I knowingly and freely assume all risks, both known and  unknown in participating this sporting event, even if arising from the negligence of the NEPA Youth Football (NEPAYF)/Progressive Speed and Strength Training, as listed above, or from any others, and I assume full and absolute responsibility  for my participation in the training activity. I assume all costs associated with such risks,  including but not limited to, testing for COVID-19, quarantine, hospitalization, disability or  death.  
 E. Release and Waiver. I hereby release NEPA Youth Football (NEPAYF)/Progressive Speed and Strength Training (PST), its members, employees, agents, contractors, volunteers, successors or assigns  from any and all claims for injury, loss, damages, actions and causes of actions,  claims and demands whatsoever, whether known or unknown and whether or not founded in fact  or in law, and of and from any and all manner of suits, liabilities, losses, covenants,  controversies, agreements, promises, damages, judgments, claims and demands whatsoever in  law or in equity including, but not limited to, those arising out of or in any way related to my  participation in the training events and all acts or omissions related thereto, whether or not
caused in whole or in part by the negligence or other misconduct of any of the parties listed above.  
 F. Indemnification. I, on behalf of myself, my child, my administrators, heirs,  successors, and assigns, voluntarily agree to release, waive and discharge, hold harmless, defend  and indemnify the above listed NEPA Youth Football (NEPAYF)/Progressive Speed and Strength Training (PST)Parties from any and all claims for injury, loss, damages, actions and causes of action, claims and demands whatsoever, whether known or unknown and  whether or not founded in fact or in law, and of and from any and all manner of suits, liabilities,  losses, covenants, controversies, agreements, promises, damages, judgments, claims and  demands whatsoever in law or in equity including, but not limited to, those arising out of or in  any way related to my participation in the sporting events as well as all acts or omissions related  thereto whether or not caused in whole or in part by the negligence or misconduct of any of the  NEPA Youth Football (NEPAYF)/Progressive Speed and Strength Training (PST)Parties.

Covid-19 Release and Wavier Signature*

NEPA Youth Football Policy on Sportsmanship

I, the parent or guardian of a NEPA Youth Football athlete, will refrain from the use of negative or derogatory language aimed at the Officials, the Coaches, NEPA Youth Football staff, my child, other players or parents. I will encourage my child and all others in the game and will let the coach be the coach. I will do my best to model the sportsmanlike behavior I wish my child to adopt and to support the coach in making this the best possible experience for my child.

NEPA Youth Football Policy on Sportsmanship Signature*