Valley Cottage Indians 2018 Cheer and Football


Parental Consent:

Your submission of this form will be used as your consent for the child named within to participate in activities involving Pop Warner Youth Football/Cheerleading and Valley Cottage Indians. You also give permission for the child named within to travel with their team/sqaud/association, in adherance with scheduled home/away game(s). You further agree that you shall not hold responsible any officer, coach or staff member of his/her Association or Organization (RCPWYFL) for any injury or damages sustained by the child named within while participating in such activities.

You also understand that your submission of this form indicates blanket approval and covers all team/squad related activities and, in the event of your absence, the right to approve and/or administer medical assistance as needed.


Please complete the following if you've registered your child for Cheer/Dance.

Thank you for your registration for the Valley Cottage Indians Pop Warner Cheer and Football Program.

Please make payment in the amount due to Valley Cottage Indians and forward your payment to:

Valley Cottage Indians
PO Box 79
Valley Cottage, NY 10989
Attn: Director, Cheer/Football
Thanks again and look forward to welcoming you and your child.

Due to the number of applications please be sure to complete the application process by sending in your payment promptly -

* required