2026 Flag Football League Registration Form

Payment Type ( Make checks payable to Smithville Park & Rec )

Gender

Player's Full Name

First NameLast Name

Date of Birth

Date

Players age as of 9/1/2026*

Preferred Age Group ( playing up only )

Players Jersey Size

Parent/Guardian's Full Name

First NameLast Name

Phone Number

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

Head Coach

Assistant Coach

Signature

I am the parent/guardian of the child listed above. I understand that participation in this sports program involves risk of injury. I agree that my child will follow all rules and safety guidelines set by the Town of Smithville and City of Amory Parks and Recreation Departments.

I release the Town of Smithville, City of Amory, Parks and Recreation Departments, sponsors, staff, and Volunteers from claims related to injuries or damages that may occur during participation in the program.

I give permission for photos of my child taken during program activities to be used by the Town of Smithville and City of Amory Parks and Recreation Departments for promotional purposes, including social media and websites.

I understand that the Town of Smithville and City of Amory Park and Recreation Departments may dismiss any player for inappropriate or unsportsmanlike conduct by the player or their parent/guardian.