Rt. 150 Vikings JFL

2024 Registration

Route 150 Vikings Prefers All Registration and Payments Be Performed Via The Web Site.

There Will Not Be Any Physical Registrations.

If You Have Any Questions Or Issues, Please Contact Us At:

Route150Vikings@gmail.com

Cheer Age Restrictions: 3rd through 8th Grade
Football Age Restrictions:
Flag: 1st & 2nd grades, or an equivocal age for home-schooled players, *cannot be 9 or older on September 1st
• Bantams: 3rd & 4th grades, or an equivalent age for home-schooled players, *cannot be 11 or older on September 1st

• Junior: 5th & 6th grades, or an equivalent age for home-schooled players, *cannot be 13 or older on September 1st
• Varsity: 7th & 8th grades, or an equivalent age for home-schooled players, *cannot be 15 or older on September 1st

Note: All grade levels refer to the grade the participant will be in the coming Fall.

PLAYER INFORMATION

* Participant First Name:

* Participant Last Name:

* Activity - Please Select Tackle For Bantams:

If Tackle, Please Select The Level:

* Street:

* City:

* State:

* Zip Code:

* Gender:

* Grade (Entering this fall):

* Jersey/Uniform Size in Fall (best guess):

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

* Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

WAIVER INFORMATION

Minor Waiver/Release Form
RELEASE OF LIABILITY FOR MINOR PARTICIPANTS
Route 150 Vikings Youth Football & Cheer

READ BEFORE Accepting

IN CONSIDERATION OF my child/ward, being allowed to participate in any way in

the Route 150 Panthers Junior Football Team (DBA / also known as Route 150 Vikings

Youth Football & Cheer) related events and activities, the undersigned

acknowledges, appreciates, and agrees that:

1. The risk of injury to my child/ward from the activities involved in the programs is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,
2. I FOR MYSELF, SPOUSE, AND CHILD/WARD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for child/ward, participation; and,
3. I willingly agree to comply with the program's stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child/ward's readiness for participation and/or in the program itself, I will remove my child/ward from the participation and bring such attention of the nearest coach or official immediately; and,
4. I, for myself, my spouse, my child/ward, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS ROUTE 150 PANTHERS JUNIOR FOOTBALL TEAM (DBA/ also know as Route 150 Vikings Youth Football & Cheer); its directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("Releasees"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, incident to my child/ward's, involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
5. I, for myself, my spouse, my child's/ward, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my child's/ward involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

I/we agree with the above *

List any allergy, medical condition, previous injury or other conditions you wish for the organization to be aware of as it impacts participation in the activity::

Hospital Preference:

Any Other Notes or Remarks for the Organization (Optional):

I am interested in volunteering to coach, please contact me regarding this opportunity.

PARENTAL/GUARDIAN PERMISSION AND EQUIPMENT CHARGE The parent(s)/guardian(s) of the above named participant, hereby give approval for participation in any and all of the activities of the Route 150 Panthers Youth Football org (referred to as the Route 150 Vikings Youth Football & Cheer (YFC) the rest of this document and other forms) during the current season. I/we assume all risks and hazards incidental to the conduct of any of the activities, including transportation to and from such activities. I/we do further release, absolve, indemnify and hold harmless Route 150 Vikings YFC, its organizers, sponsors, directors, and supervisors, any or all of them. In case of injury to my/our child, I/we hereby waive all claims against the organizers, sponsors, directors, or any of the supervisors appointed by them. I/we likewise waive, to the extent not covered by liability insurance, any claim against any persons transporting my/our child to or from activities. I/we assume full cost of all issued equipment if not returned, altered, lost, or from negligent damage.

I/we agree with the above *

PICTURE RELEASE/WAIVER The parent(s)/guardian(s) of the above named participant, hereby give approval for pictures taken of the participant during league events to be used to promote our league and events on the Route 150 Vikings YFC website (ex. team photos on website). Route 150 Vikings YFC agrees to use these images in a responsible manner keeping the safety of our participants in the highest regard. If I/we, the parent(s)/guardian(s) do not give permission, I/we will submit a handwritten letter to the Route 150 Vikings YFC organization prior to the first practice.

I/we agree with the above *

FUNDRAISING CHARGE In order to keep registration fees as low as possible, The parent(s)/guardian(s) of the above named participant, agree to participate in the designated fundraiser selling at a minimum 10 raffle tickets or paying $100 to the Route 150 Vikings per participant to satisfy fundraising requirements. I/we, the parent(s)/guardian(s) of the participant understand that I/we are making a decision to participate in the fundraising process as this is instrumental in keeping fees for the program at a minimum. This requirement is waived for Flag Football participants, but Flag players/parents are encouraged to participate.

I/we agree with the above *

EMERGENCY MEDICAL AUTHORIZATION The parent(s)/guardian(s) of the above named participant, hereby give authorization for any emergency medical treatment of the participant for any injury resulting from any activity of the Route 150 Vikings YFC. It is understood that efforts shall be made to contact the undersigned prior to rendering treatment to the injured participant. This authorization shall expire on November 1 of the year this application is signed. My son/daughter has permission to participate in Route 150 VIkings YFC. I certify that as parent(s)/guardian(s), I will not hold the team, coaches, directors, or Route 150 Vikings YFC organization responsible for any accidents or injuries that occur.

I/we agree with the above *

REGISTRATION FEES Tackle Football (Including Bantams): Registration fee is $115 which includes a $20 non-refundable deposit. Cheerleaders: Registration fee is $55 which includes a $10 non-refundable deposit. Flag Football: Registration fee is $55 which includes a $10 non-refundable deposit. ALL participants MUST furnish a COPY of their sports physical BEFORE the first practice to participate, physical may be emailed to Route150Vikings@gmail.com

Players in will need to furnish their own cleats, and padded pants for tackle levels.

I/we agree with the above *

* indicates required fields

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2024 Registration