2025 Season Registration Form

SALEM MSC YOUTH FOOTBALL LEAGUE, INC.

“The Foundation of Salem Football”
2025 Season Registration Form

Fill out the form carefully for registration
Student Name*

First NameLast Name
Birth Date*

MonthDayYear
Gender
Player T-Shirt Size*
School*

Bradie Shrum ElementarySalem Middle School
Height*
Weight*
Grade for 2025-2026 School Year*
Player's Past Football Experience - Number of Years Played*
School(s) Played For:
Position(s) Played:
Do you have a MSC Jersey from 2024:*

YesNo
2024 MSC Jersey Number:*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Player's Medical Insurance Coverage - Insurance Company:*
Policy Number:*
Guarantor:*
Guarantor / Parent E-mail address*
example@example.com
Parent Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Mobile Number*
Parent Email address:*
example@example.com
Second Parent Mobile Number:
Please enter a valid phone number.
Second Parent Email Address:
example@example.com
Emergency Contact Phone Number*
Emergency Contact Name / Relationship*
PARENT/LEGAL GUARDIAN AGREEMENT

The Salem Mid Southern Conference Youth Football League (SMSCYFL) is a youth program designed to teach children the true meaning of team sports.  Our goals are to promote positive attitudes, instill a dedication to being a team player and teach the proper skills of youth football.

This Agreement will serve as an acknowledgement by you (Parents/Guardians) that, by choosing to enroll your child in the SMSCYFL program, you will abide by all SMSCYFL by-laws, guidelines and rules indicated here.

1.     I will remember that that children participate to have fun and that the game is for them.

2.     I will never yell at or ridicule my child or other participant for making a mistake or losing a competition.

3.     Coaches will make all decisions in the areas of player evaluation and selection to the teams. Coaches will make all decisions on who plays, where they play and when they play.

4.     I will not engage in any unsportsmanlike conduct with any official, coach, player or parent , such as booing or taunting, refusing to shake hands or or using profane language or gestures.

5.     The SMSCYFL Board of Directors may suspend or dismiss any player for continuous bad behavior.

6.     The SMSCYFL has adopted a “zero tolerance” policy concerning any activities deemed detrimental or harmful to the program.  Any infraction of the “zero tolerance” policy will result in the immediate expulsion of parent/guardian and child(ren) from SMSCYFL.

7.     Coaches will do their best to inform parents of any physical or behavioral concerns to assist in the improvement of the child.

8.     Parents must not interfere with coaching during practices and games and must not interfere with the officiating during games.

9.     Parents must have their child at every scheduled practice and game time, unless there is a valid excuse.

10. Parents must make sure that their child is properly and safely equipped at all practices and games.

11. Parents are responsible for all equipment issued to their child.  Parents will be charged for any loss of equipment or unnecessary damage to the equipment.

12. Any child leaving our program during the season must return all issued equipment within 5 (five) calendar days of leaving, or the parents will be subject to a charge of $25.00 per day until the equipment is returned.

13. Any parent concern regarding coaching or SMSCYFL league operation must be submitted in writing to the Board of Directors.

14. Registration fees are non-refundable.
Signature - I have read and understood the foregoing Parent / Legal Guardian Agreement*

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Salem MSC Youth Football League, Inc.

PARENT/GUARDIAN CONSENT TO PARTICIPATE AND RELEASE

In exchange for participation in the activity of football organized by the Salem Mid Southern Conference Youth Football League, Inc. (SMSCYFL) and use of the property, facilities and services of the SMSCYFL and Salem Community School Corporation, I AGREE for myself and my family the following: I agree to follow and observe the rules or warnings given by SMSCYFL. I recognize that there are certain risks associated with my child’s participation in youth football and I assume full responsibility for personal injury to myself and family members and further release and discharge SMSCYFL, Salem Community School Corporation, representatives, coaches, officers and officials for injury, loss or damage, whether caused by the fault of myself, family, SMSCYFL, or third parties. I agree to indemnify and defend SMSCYFL against all claims, causes of action, damages, judgments, costs or expenses. I confirm that the participant has adequate family insurance and that it is my responsibility to provide medical insurance hereby waiving all liability or rights against SMSCYFL from any claims or actions. I agree to pay for all damages caused to SMSCYFL caused by neglect, recklessness, or willfull actions resulting in damage caused by myself or family.

I have received shoulder pads, a helmet, game pants/pads that belong to SMSCYFL. It will be my responsibility to return all issued equipment at the end of the season in good repair or pay replacement costs of $250.00.
Signature - I have read and understood the foregoing Consent to Participate and Release.*

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SALEM MSC YOUTH FOOTBALL LEAGUE, INC.

2025 Season Registration Form