BLFA Fall 2025 Registration Form

Child's Name

First NameLast Name

Child's D.O.B

Age as of September 1, 2025:

Pick one:

Age Level (u = & under):

Parent's Name

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

If your child is playing flag, select the correct size below. If your child is playing tackle, fitting will be on a date TBD.

Shirt Size:

Short Size:

Emergency Contact Name

First NameLast Name

Does the athlete have any allergies, chronic illnesses, or medical conditions? If yes, please list & describe here.

Is the athlete prescribed an inhaler, epipen, or any other medical devices? If yes, please explain any instructions here.

Emergency Contact Number

Please enter a valid phone number.Format: (000) 000-0000.

Is this your child's first year playing or cheering for Batesburg-Leesville Football Academy?

If you answered yes to the question above, please upload your child's birth certificate here.

If you played last year, enter your jersey number.

If you didn't play last year, list three numbers you would be interested in having.

Release & Liability

In Consideration of my/our child being allowed to participate in any way for the Batesburg-Leesville Football Academy (BLFA) Youth Sports program for the 2025 Fall season, it's related events and activities, the undersigned acknowledges, appreciates, and agrees that:

The risk of injury from the activities involved in this program is significant, including the potential risk for permanent paralysis and death, and while particular rules, equipment and personal disipline may reduce the risk, the risk of serious injury does exist; and

I knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the releases or others, and assume full responsilbity for my participation; and I willingly agree to comply with the stated and customary terms and conditions for participation. If however, I observe an unusual and significant hazard during my presence or participation, I will bring such to the attention of the nearsest official immediately; and

I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release, indemnify, and hold harmless BLFA Youth Sports, and it's officers, officials, agents and/or volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event, with respect to any and all injury, disability, death, or loss or demage to person or property, wheather arising from the negligence of the releases or otherwise, to the fullest extent by law.

If a child leaves a practice or game for any medical reason, he or she cannot return without medical clearance from a physician. At any time, a coach can require medical clearance of a player to be able to participate or play at his/her own discretion.

Photo release statement: I also hereby consent, without further consideration or compensation, to use (full/partial) of all photos, audios or videos made of my child or family members during BLFA sporting events, for the purposes of events documentation, promotional materials or web content. Further, I release BLFA and its volunteers from any liability, which may arise from the use of those photos.

I have read this release of liability and assumption of risk agreement. I fully understand its terms. I understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.

Type your First & Last Name here to serve as your signature.

Registration Fee

Flag Registration

Ages(4-8)

$100.00

Tackle Registration

Ages(9-12)

$135.00

Cheer Registration

Ages(6-12)

$135.00

Subtotal

Tax

Total

Payment Methods

Credit Card

Apple Pay

Google Pay

Cash App Pay

BLFA Fall 2025 Registration

Registration Fee*

Payment Methods

Registration Fee