MYSA / YMCA Flag Football Registration

Player's Full Name*

First NameLast Name

Grade in school *

2025-2026 SCHOOL YEAR

Birth Date*

Did child play for a YMCA Flag Football team last year?*

I would like to head coach this team (if available)I can head coach the team if neededI can assist the head coach with practice & gamesI can assist the head coach with electronic communication to teamI will be unable to assist with coaching

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Home Phone

Format: (000) 000-0000.

Father's Name*

First NameLast Name

Father's Cell Phone*

Format: (000) 000-0000.

Father's E-mail address *

Mother's Name*

First NameLast Name

Mother's E-mail address*

Mother's Cell Phone*

Format: (000) 000-0000.

PLEASE READ BEFORE SUBMITTING THIS FORM

"PARTICIPATION / PARENTAL ASSUMPTION OF RISKS AND RELEASE"

Participation in any athletic activity may involve injury of some type to either yourself or a fellow athlete. Such injury can include direct or emotional injury experienced as a result of witnessing or actually inflicting injury to another. The severity of such injury can range from minor cuts, scrapes, or muscle strains to catastrophic injury, such as complete paralysis, or even death. Such injury can impair one’s general physical and mental health and hinder one’s future ability to earn a living, to engage in other business, social, or recreational activities, and generally to enjoy life. The purpose of this WARNING is to bring to your attention the existence of potential dangers associated with athletic participation. There is, however, always risk of other types of injuries or the risk of injury or death resulting from other causes not specified here.

The purpose of this WARNING is also to aid you in making an informed decision as to whether you or your child or ward should participate in this activity and, as a condition of such participation, sign the foregoing ASSUMPTION OF RISKS AND RELEASE FROM. In addition, its purpose is to make you aware that as an athlete, or as a parent or guardian of an athlete, it is your responsibility to learn about and/or to inquire of coaches, physicians, or other knowledgeable persons about any concerns that you might have at any time regarding athletic safety.

I have read the above ASSUMPTION OF RISKS AND RELEASE FORM. I release the Malcolm Youth Sports Association and the YMCA (when applicable) and all of its coaches from all claims on account of any injuries or illnesses, including COVID-19, which may be sustained by me/my child while participating in the above sponsored activity. If medical attention is required for injury or illness while participating in such activity, as parent/guardian I give my permission for such medical care.

MYSA Flag Football Refund Policy

In the event that the YMCA cancels their league for any reason, all registrations will be refunded the amount paid during registration less any late fees paid and less $5.00 to cover PayPal fees paid by MYSA.

Digital Signature (typing your full name here indicates you've read and agree to the above release)*

Today's Date

MonthDayYearHourMinutesAM/PM Option

If you are a YMCA member, use coupon code "YMCA" below to reduce your registration to the YMCA member rate.

Payment using PayPal (you will be redirected to a PayPal site to complete payment processing). A YMCA Jersey is required to play in the YMCA Flag Football league. If you need a jersey you will need to purchase one at the park before your first game, or at the Youth Sports office Monday - Friday 8:00AM - 5:00PM. *

MYSA Fee (required)$10.00

YMCA Flag Football Fee$64.00

Parks & Rec Flag Football Fee $98.00

(2nd Graders)

Enter coupon

Total $0.00

Data To Paypal*

MYSA / YMCA FLAG FOOTBALL REGISTRATION 2025