2019 Flag Football (Grades 1st & 2nd)



Having your child’s Physician give a physical exam before participating in Football or Cheerleading is supported by and encouraged by TIMBERLANE JUNIOR FOOTBALL/CHEERLEADING, but is not mandatory.

TO WHOM IT MAY CONCERN: In the case of an emergency, by authorization of my signature below, I hereby allow TIMBERLANE JUNIOR FOOTBALL/CHEERLEADING and/or its designee(s) to administer first aid, and/or make arrangements for Emergency Transportation to medical facilities for treatment, if unable to contact me in a reasonable time frame.

The undersigned hereby indemnifies and agrees to hold harmless, TIMBERLANE JUNIOR FOOTBALL/CHEERLEADING AND/OR IT’S DESIGNEE(S) from any claims and/or law suits arising from said treatment. Also, I hereby agree to assume all responsibility for any injury or injuries, which he/she may hereafter sustain under any circumstances pertaining to involvement in TIMBERLANE JUNIOR FOOTBALL/CHEERLEADING. This also includes any and all League functions/events, and/ or any other activity(s), event(s) associated with TIMBERLANE JUNIOR FOOTBALL/CHEERLEADING.

**All participants are covered by excess accident insurance. However, Parents will be responsible for the first $500.00 (FIVE Hundred Dollars) for each injury in excess of their personal collectible insurance. Not having health insurance will not prohibit your child from participating. In the case of an injury in which medical treatment becomes necessary, it is my responsibility to pick up my child at the medical facility, NO matter where that facility is located, and if possible, accompany my child to said medical facility. All injuries and/or claims must be reported within 24 hrs of injury to your child’s head coach and/or a TJF board member. Claims for insurance must be filed by November 16, 2019.


Statement of Intent & Release Form

Timberlane Junior Football and Cheer regularly maintains a website and Facebook page for players and cheerleaders: www.leaguelineup.com/welcome.asp?url=timberlanetornadoesfootballandcheer. The website as well as Facebook page is informational for players, cheerleaders, parents, fans and others. As part of these websites, individual and action photographs are routinely displayed. No individual photographs will be displayed on these websites without the express written permission of the parent/legal guardian of the player/cheerleader. However, action photographs may include players/cheerleaders whose parent/legal guardian has not given consent. Without consent, all reasonable efforts will be made by Timberlane Junior Football to protect the player/cheerleader’s identity.

Having read and understood the above, I hereby:

GIVE MY CONSENT AND PERMISSION for my player to have photographs and information displayed on TIMBERLANE JUNIOR FOOTBALL’s PLAYER and CHEERLEADER WEBSITE AND FACEBOOK PAGE. In giving this consent and permission, the undersigned, its successors and assigns, hereby indemnifies and agrees to hold harmless TIMBERLANE JUNIOR FOOTBALL/CHEERLEADING, it’s BOARD, members, and other involved personnel and volunteers from any harm, claims, or damages which may result from the Participant’s inclusion in the WEBSITE/FACEBOOK PAGE by TIMBERLANE JUNIOR FOOTBALL.

FEES REQUIRED FOR PARTICIPATION (Separate checks are required for each fee):

I understand that my registration is not complete until I have submitted the following fees:

$115.00 Registration fee due now, $50.00 earned back upon sale of all raffle calendars. No refunds after the end of the first week of practice.

$125.00 Parent Volunteer Fee, Check post-dated to 11/1/19, Returned at end of season if commitment has been met.

Checks can be sent to:
Beth Keane
1 Stewart Farm rd
Atkinson, NH 03811

Tornadoes Calendar Raffle Instructions:

Timberlane Jr Football and Cheer will be holding a Calendar Raffle for the month of October.

How it Works

1. Starting October 1 st , a drawing will take place each day. The ticket picked, wins
that day's cash prize
2. Winning tickets will go back into drawing.
3. All prizes will be mailed out in a timely manner.
4. Every player and cheerleader will be required to sell 1 (one) book of calendar
raffles. Additional books will be available.
A. Players and Cheerleaders participating on tackle teams/squads are required
to sell a book of 10
B. Players and Cheerleaders participating on flag teams/squads are required to
sell a book of 5
5. Calendar Raffle Books are to be prepaid. You must pick them up at sign ups.
Those who sign up online, arrangements will be made for pick up/delivery.
6. Once calendars are sold: You keep the money as reimbursement for prepaying,
just turn in the raffle stubs. Stubs must be turned by Sept 30th .
A. Players return to yours to your respective team mom.
B. Cheerleaders return yours to your respective head coach.

PLEASE NOTE: The Player and Cheerleader who sells the most calendars will each receive a
$100.00 Visa Gift Card.


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