Clone of Jackson Pee Wee Player Registration Form

Jackson Pee Wee Football Registration

Fill out the form carefully for registration
Student Name

First NameLast Name
Parent or Guardian Name #1

First NameLast Name
Parent or Guardian Name #2

First NameLast Name
Phone Number #1
Format: (000) 000-0000.
Phone Number #2
Format: (000) 000-0000.
Student Grade for 2026-2027 school year
If your child has played Jackson Pee Wee Football in a previous year, what team were they assigned to?
Birth Date (please make sure this is accurate)

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail
example@example.com
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Format: (000) 000-0000.

Parent Agreement

We, the undersigned, being the parents/guardians of the child registered in this form, request that said child be allowed to participate in the Jackson Sideliners Club, Inc. Pee Wee Football Program. We understand that the Jackson Sideliners Club, Inc. is strictly a non-profit volunteer club. We further understand that the application fees paid, and all monies raised by various fundraising activities of the club are used strictly for the operations and maintenance of the program.

By my/our signing of this document, I/we certify:

1. That we have read this document in its entirety.

2. That we have had this document explained to us, and have had all of our questions answered, regarding the program.

3. That we hereby waive, and forever discharge, any and all rights, claims or other legal actions, we may have, against anyone participating in, coaching in, or administering this program, for injuries suffered by our child as a result of their participation in the program.

4. That to the best of our knowledge, our child is in good health and physical condition, has no physical condition or problem which would hinder their participation in this program or cause the program to be injurious to his health or well-being.

By my/our signing of this document, we further promise:

1. To return all equipment assigned to our child, in essentially the same condition, as when received, except for normal wear and tear.

2. To reimburse the Club for equipment damaged as a result of usage in excess of normal wear and tear

3. To reimburse the Club for equipment not returned within 10 days of the designated turn in date at the end of the season.

4. To sign up and work ONE game in the concession stand. I will sign up upon Equipment Pick up. I understand that there are NO exceptions and my son or daughter will not be issued any equipment or eligible for the program unless I sign up for ONE game.

5. We further release our child for emergency medical treatment necessitated by his participation in the Jackson Sideliners Club, Inc. Pee Wee Football Program.
Parent Agreement Signature

2026 Jackson Pee Wee Football Program

Conduct of Parents

This is the 39th year for the Jackson Pee Wee Football Program and our parents play an important role in the success of the program. Your son/daughter will learn sportsmanship, teamwork, discipline, and how to play the great game of football. By having your son/daughter involved in the Jackson Pee Wee Football Program, you as a parent/guardian and/or relative are representing the program and it is vital that you conduct yourselves in an appropriate manner and show good sportsmanship at all times.

We have put together a set of rules that each parent/guardian and/or relative will follow. If you have any issues with these rules prior to the start of the season, then please do not enroll your son/daughter in our program. If a rule is violated by the parent/guardian and/or relative or the player on the team then that player will be permanently removed from the team and not allowed to participate in the Jackson Pee Wee Football Program. THERE WILL BE ZERO TOLERANCE TOWARDS THESE RULES.

The Rules are as follows:
- There will be no derogatory remarks made towards the coaches, players, or referees at any time during the season. There will be no misuse of social media in this regard as well. This includes but is not limited to yelling, booing, taunting, using profane language, gestures, or in any way disrupting a game or practice. Remember the coaches will determine who gets to play and when they get to play. There may be times when all the players do not get to play in a game.
- No parent/guardian and/or relative will be allowed on the practice or game field at any time unless authorized by a coach or the Jackson Pee Wee Football President.
  Do not call the coaches unless it is an emergency. All issues that need to be discussed with the coaches should be conducted before or after the practice.
- No parent/guardian and/or relative will coach their child or other players during the games or practices unless they are one of the official coaches of the team.
I, as Parent/Guardian of my child understand that it is my responsibility to uphold these rules and to make sure that any Guardian/Relative understands that their actions could remove my child/player from the 2025 Jackson Pee Wee Football Program and beyond.
Conduct of Parents Signature

Little Ohio Heritage Conference

2026 League Registration Form

I/We the parents of the above name participant of Pee Wee Football, hereby, give my/our approval to participate in all Little Ohio Heritage Conference activities.

I/We know that participation in football may result in injuries and protective equipment does not prevent all injuries to players. I/We assume all risks and hazards incidental to such participation, including transportation to and from activities, and do hereby waive, release, absolve, indemnify and agree to hold harmless the local league, the Little Ohio Heritage Conference, organizers, sponsors, supervisors, participants and persons transporting my/our child to and from activities from claim arising out of injury to my/our child to and from activities from claim arising out of injury to my/our child whatever the cause except to the extent and in the amount covered by accident or liability Insurance.

I/We will furnish a copy of a certified birth certificate and last year’s final grade card as required by League Officials
Parent/ Legal Guardian Signature #1
Parent/ Legal Guardian Signature #2
Please indicate any physical limitations or ailments:
Name of family insurance plan:

Concussion safety is important in all sports. Please Click the link above for the Concussion Information Sheet: For Interscholastic Athletics. Sign below to verify that you have received and read the information provided by the Ohio Department of Health

In accordance with this law, the Ohio Department of Health, the Ohio Department of Education, the Ohio High School Athletic Association, the Ohio Chapter of the American College of Cardiology and other stakeholders jointly developed guidelines and other relevant materials to inform and educate students and youth athletes participating in or desiring to participate in an athletic activity, their parents, and their coaches about the nature and warning signs of sudden cardiac arrest. Please Please click the image above to access all information regarding Lindsey's Law. When you have reviewed all of the information provided by the Ohio Department of Health, please sign below.

Additional Paperwork and Fees

All Fees and Paperwork listed below are due on July 7th. If paperwork and fees are not turned in by July 20, 2026, equipment will not be destributed

1. Birth Certificate- paper copy for new players- You do not need this if your child played last season. Please do not bring the original copy, we need a copy to keep on file

2. Final Grade Card for the 25-26 School year. A copy is needed for our team book to verify grade level for league requirements.

3. $35 Insurance Fee- Checks made payable to "Jackson Sideliners Club" (if more than one child is playing, the above fee covers all in family)

4. Raffle Tickets- $50 (10-$5tickets) you may pick up Raffle Tickets on July 7th and due on July 20th

5. Your Designated Grade Level Drinks- List will be handed out on July 7th and due on July 20th

Thank You!
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Jackson Pee Wee Football Registration