(NVYFL) REGISTRATION TEAM: RC RAIDERS

Jersey # Last Season(if a returning player) *

ALL PLAYERS: RC RAIDERS REQUIRES

1. Copy of player's birth certificate.

2. PLAYER/PARENT Code of Conduct Form Signed

3. PLAYER REGISTRATION FEE PAID IN FULL

Completing all 3 steps will finalize and secure your player's spot on RC RAIDERS.

Payment Options: Cash, Check(made out to SLATE VALLEY YOUTH ATHLETICS) or VENMO payment @RCRAIDERFOOTBALL

Name*

FIRST NAMEPLAYERS LAST NAME

GENDER*

BIRTHDATE*

Date

HEIGHT*

WEIGHT*

PLAYERS SCHOOL IN THE FALL:*

GRADE IN THE FALL of 2025:*

ADDRESS PLAYER RESIDES*

PLAYER LIVES WITH*

Parent/Guardian A Relationship*

Name*

Email*

example@example.com

Address*

Phone #*

Cellular Phone*

Place of Work

Work Phone #

Parent/Guardian B Relationship

Name

Email

example@example.com

Address

Phone #

Cellular Phone #

Place of Work

Work Phone #

PLAYERS PHYSICIAN: *

PHYSICIAN'S PHONE #:*

MEDICAL INSURANCE COMPANY*

POLICY NUMBER*

MEDICAL PROBLEMS, ALLERGIES, MEDICATIONS PLAYER IS TAKING OR TAKES ON A REGULAR BASIS*

The League carries NO medical insurance must have medical insurance to play LOCAL EMERGENCY CONTACT Other Than Parent. NAME: *

PHONE*

RELATIONSHIP TO PLAYER:*

PLEASE INDICATE IN WHICH AREA(S) YOU CAN HELP.

PARENTAL RELEASE I/We certify that I/we am/are the parent(s) or legal guardian(s) of 'player' and that he/she is, to the best of my/our knowledge, physically fit and able to participate in unrestricted activities related to practice and games in the sport of football. If 'player' has a history of serious illness or injury a note signed by a physician clearing the individual for full participation in all NVYFL activities must accompany this form.

GENERAL RELEASE The undersigned individual, in consideration of his/her player's participation in the Northern Vermont Youth Football League, covenants and agrees to hold harmless NVYFL, its agents, team organizations, coaches and all league administrators and persons transporting 'player' to/from activities, against all liabilities, expenses, costs and claims arising from or in connection with any suit, claim or demand of any kind and character brought or maintainedin connection with the player's participation in the NVYFL and any associate member team. The program includes the use of football players' equipment, and the preparation for a participation in tackle football games-a contact sport-under the instruction and supervision of adults. NVYFL hereby informs both the player and his/her parents that there are risks inherent in athletic participation. I/We agree to return all equipment assigned to my/our child, or be sent a bill for it.

MEDICAL RELEASE I/We grant permission to NVYFL coaches/staff to render first aid to 'player'. In case of emergency, I/we hereby authorize him/her to be treated by Certified Emergency Personnel and understand that I/we and/or his/her emergency contact (parents first) will be contacted as quickly as possible.

WEBSITE RELEASE I/We give permission for 'player's picture and name (first initial, last name) to appear on the NVYFL website and/or associated team site. Further I/we understand that the content of the website is at the sole discretion of the website administrator and NVYFL and that neither guarantee that his/her neither picture nor name will appear. This also includes Facebook/Social Media content on both team/public pages.

By signing below, the player and parents acknowledge all information and herein give their consent to participate in the NVYFL program.

PARENT/GUARDIAN INITIALS DENYING WEBSITE/SOCIAL MEDIA RELEASE:

PARENT OR GUARDIAN PRINTED NAME*

DATE*

Date

2025 NORTHERN VERMONT YOUTH FOOTBALL LEAGUE

(NVYFL) REGISTRATION TEAM: RC RAIDERS