Participant InformationPlease Check One: *Returning PlayerNew PlayerFirst Name *Middle NameLast Name *Street Address *Apartment, suite, etcCity *State *ZIP / Postal Code *Date of Birth *Age on 9/1/2024 *Current School *Grade entering 9/2024 *(use 'K' for kindergarten)Lives With: *MomDadOthercheck all that applyGuardian's Name *Guardian's Phone *Email Address *Parent's/Guardian InformationMother's First NameMother's Last NameMother's PhoneMother's Email AddressFather's First NameFather's Last NameFather's PhoneFather's Email AddressTEAMSSelect only 1, levels are listed below for reference Cheerleaders (Grade as of 9/2024)A Cheerleading: Grades 6 & 7B Cheerleading: Grades 4 & 5C Cheerleading: Grades 2 & 3Flag Cheer: Grades K & 1 Football Players (Grade as of 9/2024)A Football: Grades 6 & 7B Football: Grades 4 & 5C Football: Grade 3Flag Football: Grades 1 & 2 NEW! Intro to Football: KPlayer Team *Intro to Flag FootballGrade Level as of 9/24PledgeAll players and cheerleaders must read the following statement and check the box that they agree with it:I will maintain at least a "C" average in school, abide by the official's decisions, show good sportsmanship, listen to my coaches & organization officials, not use foul language, and not damage or deface property, buildings, or equipment.Yes, I agree with terms. *Procedure for Medical AttentionEmergency Contact and Insurance InformationIn the event of an injury to your child, it is necessary that you furnish the name of an emergency contact / relative who will assume temporary care of your child until you can be reached.Name of Emergency Contact *Relationship to Child *Phone # of Emergency Contact *Parent's Insurance Company *Contract Number *Parental Consent & AcknowledgementsAll Parents/Guardians must read the following statements and check the box that they agree with it:Permission to ParticipateI understand that football & cheerleading is a high impact and contact sport and that my child can be injured while participating as either a "Player" or "Cheerleader". I also understand that an injury can be of minor or major variety. With this, I give my permission to my child to participate in this program. RYFC RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT In consideration of participation in and/or with Rochester Youth Football, Inc. and it’s League Members (herein-after referred to as "the League"), the undersigned (hereinafter "Releasor") agrees as follows: I am the participant or parent and/or legal guardian of the "Participant" (listed on page 1). I have the legal authority to enter on behalf of Participant into this Release and Waiver of Liability, Assumptions of Risk and Indemnity Agreement (hereinafter the "Agreement"), with the intent to enter into a legally binding agreement, on behalf of Participant. I understand and agree that participation in the League activities and events (hereinafter referred to as "Activities") is voluntary and is conditioned upon my acceptance of registration and this Agreement, which will waive certain rights for both myself and Participant. Participant has requested to participate in the Activities and I, for myself and on behalf of Participant, agree as follows: I understand the nature of the Activities and I hereby represent that Participant is qualified, in good health, and in proper physical condition to participate in such Activities. I give my permission and consent for Participant to take part fully in all Activities. I further represent that I have received clearance from Participant's medical doctor that Participant is medically allowed to participate in the Activities and that there are no medical limitations on Participant's ability to participate in the Activities. I acknowledge that if I and/or Participant and/or any physician treating Participant believe the Activities are unsafe for Participant, I or Participant will immediately discontinue Participant's participation in the Activities. I fully understand that the Activities involve risk of serious bodily injury, including permanent disability, paralysis and death, which may be caused by Participant's conduct, by the conduct of others participating in the Activities, by the conditions in which the Activities take place, or by the conduct of the "Releasees" (identified below). I understand that the risks of participating in the Activities may be caused in whole or in part by: my own actions or inactions; the actions or inactions of other participants; the actions or inactions of spectators or other pedestrians; and/or the acts, inactions, or negligence of the Releasees. I also fully understand and acknowledge that there may be other risks arising from or associated with the Activities either not known to me or not readily foreseeable at this time and I on behalf of myself and participant fully accept and assume all such risks and all responsibility for losses, costs, and damages that I and/or Participant may incur as a result of Participant's participation in the League and its Activities. In consideration for Releasee's provision of the opportunity to participate in the League, I for myself and on behalf of Participant, hereby forever release, discharge, and covenant not to sue Rochester Youth Football and Cheerleading, Inc., their Executive Officers, their League Members, respective agents, officers, directors, employees, volunteers, other participants, any sponsors, advertisers, and if applicable, owners and lessors of premises on which the Activities takes place, (collectively and individually referred to herein as "Releasees") from all liability, claims, demands, losses, or damages on my account or on account of Participant caused or alleged to be caused directly or indirectly, in whole or in part by the Releasees conduct or Releasees failure to act or make safe or in any way arising from or related to Participant's participation in the League and the Activities or otherwise. I further agree that if, despite this Agreement I, or anyone on my and/or Participant's behalf makes a claim against any of the Releasees, I will indemnify and save and hold harmless each of the Releasees from any loss, liability, damage, or cost which any may incur as a result of such claim. Releasor shall indemnify, defend and save and hold harmless, Releasees from and against all fines, penalties, claims, losses, costs, damages, suits and expenses including, but not limited to, attorney's fees, court costs and expert fees resulting from, caused or contributed by or in any way relating to or arising out of Participant's participation in the League or the Activities. In the event of Participant injury, accident, or illness, I consent to Participant receiving emergency medical care and treatment as deemed advisable in the best judgment of appropriate League Member personnel and/or appropriate medical professionals. If necessary, I authorize appropriate League Member personnel to consent to such medical care and treatment on Participant's behalf. I agree to assume liability for any and all medical costs incurred as a result of Participant's participation in the Activities that are not covered by insurance, including but not limited to costs of: medical care and treatment, ambulance services, hospital stays, and physician and pharmaceutical goods and services. I agree to indemnify and hold harmless the Releasees from all liability for such costs. I grant permission to Rochester Youth Football and Cheerleading, Inc. and its League Members to use Participant's photograph and/or any other record of Participant's participation in the Activities for any legitimate purpose. I understand that any and all photographs, motion pictures, recordings, and/or likenesses of Participant captured during the Activities by Rochester Youth Football, Inc., its League Members, its affiliated entities or contractors, and/or the media become the sole property of Rochester Youth Football and Cheerleading, Inc. I grant the right, permission and authority to Rochester Youth Football and Cheerleading, Inc. to use Participant's name and any such photographs, motion pictures, recordings, and/or likenesses for any legitimate purpose, including but not limited to promoting, advertising, and marketing activities. I further understand that Rochester Youth Football and Cheerleading, Inc., as sole owner, has the full right to sell and/or profit from the commercial use of such photographs, motion pictures, recordings, and/or likenesses. The above-described release, discharge and covenant not to sue is made on my own behalf and on Participant's behalf and on behalf of my and Participant's heirs, executors, administrators, legal representatives and assigns and I recognize that my signature on this Agreement binds all such parties as well as myself. I acknowledge that I have had the opportunity to review this Agreement with participant and with any advisor(s) of my choosing, including legal counsel, before signing it. I have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT and fully understand it. I acknowledge that I am giving up substantial rights - my own and/or those of Participant - by signing this Agreement and have signed it freely, voluntarily and without any inducement or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and that I have had an opportunity to consult with an attorney regarding the terms and advisability of signing this Agreement. I also agree that if any portion of this Agreement is held to be invalid, the balance of the agreement, notwithstanding such portions invalidity shall continue in full force and effect. Yes, I agree with terms. *All Parents/Guardians must read the following statements and check the box that they agree with it:Parent / Legal Guardian Pledge All parents & legal guardians must read & sign these rules and code of conduct. Be sure you understand them to prevent any misunderstanding at a later date. If you have any questions concerning any of these rules, please contact an organization board member prior to signing this document. I understand that the game and events are for the children, not the adults. I will encourage good sportsmanship. I will set an example by demonstrating good sportsmanship and positive support for all players, coaches, officials, board members, and other adults at all RYFC functions (This includes practices, games, and other events). I will provide support for coaches and RYFC staff working with my child to provide an enjoyable experience for all. I will demand a drug, alcohol, and tobacco free sports environment for my child and agree to refrain from their use at RYFC events. I will require that my child treat other players, coaches, officials, and adults with respect. I will treat other players, coaches, officials, and adults with respect. I will require and assume responsibility for my child treating assigned equipment with care. I will assume thefinancial responsibility for all lost or damaged equipment. I will abide by the RYFC and organization rules and regulations. No persons other than players, coaches, medics, or RYFC officials are allowed on the field. There are no exceptions to this. All game filming must be done outside the sectioned off area. I will refrain from coaching my child from the spectators area, as I understand that there will be no non-certified coaching allowed. I understand by checking the box that if I violate this pledge, I may be placed on probation or suspended for a period of time. Serious infractions may result in being removed from the program. *Photo Release - All Parents/Guardians must read the following statements and check the box that they agree with it:I grant the RYFC and its member organizations, their representatives and designees the right to take photographs of my child in connection with normal RYFC related activities. I authorize the RYFC and its member organizations, their assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that the RYFC and its member organizations may use such photographs of my participating child with or without their name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content. Yes, I agree with terms. *Emergency Contact Authorization - All Parents/Guardians must read the following statements and check the box that they agree with it:I, the undersigned, do hereby authorize officials of the Rochester Youth Football & Cheerleading League to contact directly the person(s) named on this contract form and do authorize an attending physician(s) to render such treatment as may be deemed necessary in an emergency, for the health of said child. I will not hold the RYFC, Inc. financially responsible for the emergency care and/or transportation for said child. Rochester Youth Football and Cheerleading (RYFC) has accident insurance coverage for medical and hospital expenses with a $500.00 deductible for each accident incurred. This insurance is secondary coverage, following he parent’s own medical insurance coverage. This coverage only applies to accidents directly related to authorized RYFC activities, events, or functions. Any injury that requires medical attention must be reported to team officials immediately and the proper claim forms filled out and submitted to the League office.Yes, I agree with terms. *Required DocumentsPLEASE PUT CHILD'S FIRST AND LAST NAME IN THE FILE NAME ex) AlisonSmithbirthcert.pdfPhotograph - Attach Recent Photo Here *Choose FileNo file chosenDelete uploaded fileThe photograph must be from within the past year and be clearly visible of the participant from shoulders up A school picture is preferred. This is for certification purposes, it allows a league certifier to be able to see that the file we present to them, of said athlete, matches the athlete that is standing in front of them. These photos are not used in any other purpose and are handled discreetly the same as if it were a med form or bc. File must be in the format of JPEG or PDF and under 2MB in file size. **NOTE** Please include the child's first and last name in the document file name.Proof of Grade *Choose FileNo file chosenDelete uploaded filePreferred: first page of child's report card from the current school year. We can also accept a screenshot of the child's Infinite Campus home page, which shows their current grade in school (grade and 23-24 school year must be visible)Medical / Physical Appraisal Form *Drag and Drop (or) Choose FilesA copy of your child's most recent medical / physical appraisal form from their pediatrician must be attached to application. The form must be dated on or after August 1st, 2023 to be considered valid for the upcoming season. The form must indicate that your child is physically qualified for sports with no limitations for football or cheerleading. The form must be signed / stamped and dated at the physician's office. Undated documents will not be accepted. File must be in the format of JPEG or PDF and under 2MB in file size. **NOTE** Please include the child's first and last name in the document file name. If the only health appraisal you have is dated before 8/1/23, submit what you have. You will be required to submit an updated form before the child will be allowed to practice.Payment OptionsMust submit online payment at time of registration for it to be valid.SUBMIT FORMPlease do not fill in this field. 2023-05-24