Suffolk Raven's Football Registration

Participant's Full Name*

First NameLast Name

Preferred Nickname

Date of Birth*

Date

FootballCheerleading

Select your child’s program based on their age on July 15, 2026. If unsure, we will place them in the appropriate division.

6U (Ages 5-6)8U (Ages 7-8)10U (Ages 9-10)12U (Ages 11-12)

Tiny-Mite (Ages 5–6)Mitey-Mite (Ages 7-8)Jr. Pee Wee (Ages 9–10)Pee Wee (Ages 11–12)

Uniform Size*

Additional Notes (allergies, medical conditions, etc.)*

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Address*

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Parent/Guardian Email*

example@example.com

Parent/Guardian Phone Number*

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

Emergency Contact Name (if different from Parent/Guardian)

First NameLast Name

Emergency Contact Phone Number

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

Liability Waiver & Acknowledgment of Risk

I, {q5_fullname3}, the undersigned parent or legal guardian of {q2_fullname0}, hereby acknowledge and understand that participation in the Suffolk Ravens Football & Cheerleading program involves inherent risks, including but not limited to physical injury, illness, permanent disability, or death.

I understand that football and cheerleading are physically demanding activities that may involve contact, collisions, falls, and other risks that cannot be entirely eliminated despite proper coaching, equipment, and supervision.

On behalf of my child and myself, I voluntarily assume all risks associated with participation in the Suffolk Ravens Football & Cheerleading program.

I hereby release, waive, and discharge the Suffolk Ravens organization, its coaches, volunteers, staff, sponsors, and affiliated organizations from any and all liability, claims, demands, or causes of action arising out of or related to any injury, loss, or damage sustained by my child while participating in team activities, including practices, games, travel, and related events.

I certify that my child is physically able to participate and has no medical conditions that would prevent safe involvement, or that I have disclosed any such conditions to the organization.

In the event of an emergency, I authorize the Suffolk Ravens staff and volunteers to obtain medical treatment for my child, including transportation to a medical facility if necessary. I understand that I am responsible for any medical expenses incurred.

By signing below, I acknowledge that I have read, understand, and agree to this liability waiver and assumption of risk.

Signature*

Please verify that you are human*