SOUTH JACKSON EAGLES YOUTH FOOTBALL

Subscribe to our Newsletter

2022 SJ Eagle Registration Form

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

* Home Phone:

* Parent, Guardian or Adult E-mail:

PARENT/GUARDIAN #1

Firstname:

Lastname:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

Any known health problems (asthma, heart, etc.):

Relationship to Player:

Insurance Carrier:

Policy #:

WAIVER INFORMATION

Medical Release and Waiver of Liability I hereby certify that I am the parent and/or legal guardian of the player above. I also certify that my child is physically fit for strenuous activity according to our family physician. In the event that my child is injured or becomes ill, I hereby grant mypermission on our family’s behalf, in case of emergency, for the South Jackson Eagles staff to provide or seek medical assistanceas may be deemed necessary under then-existing circumstances. Further, I understand fully that individuals who participate infootball activities are doing so at their own risk. I acknowledge that the coaches and trainers of the South Jackson Eagles YouthFootball are not responsible for any injury that may occur to individuals participating in any football activity, and accordingly,will not file legal action against the team or coaching staff of the South Jackson Eagles Youth Football Participation is on a voluntary basis only

I/we agree with the above *

* indicates required fields

OUR SERVICES

LOCAL SPORTS

ELITE

2022 SJ Eagle Registration Form