footballsignupform

Receipt #__________

OLIVER SPRINGS YOUTH CLUB
Football Sign-up

Paid_____________
Cash____________
Check #__________
Other____________

I, the undersigned, hereby give permission for:

__________________________________________ ____________________________________________
Child's Name Date of Birth (Must be 5 before or on May 1st)

To participate in the little league cheerleading and football program offered by the Oliver Springs Youth Club. Furthermore, I
hereby relieve OSYC and the league in which it participates of all liabilities, including medical expenses, should the above
named child incur any injury while participating in, traveling from, prior to, and immediately after any and all scheduled Oliver
Springs Youth Club approved events (games, scrimmages, practice sessions, etc.). I further agree to reimburse OSYC the
replacement cost for any and all items lost, stolen, and/or otherwise rendered unusable (as determined by the OSYC) that
are issued to the child for participation in this program. I further relieve OSYC of any responsibilities from the loss and/or
theft of any and all personal items. All participating players are expected to display good sportsmanship at all times.

Replacement Costs: Helmet - $125.00, Shoulder Pads - $50.00, Game Pants - $45.00, Game Jerseys - $45.00, Practice
Pants - $20.00, Chin Straps - $5.00, Thigh Pads - $10.00, Knee Pads - $10.00, Tail Pad - $5.00, Hip Pads - $10.00.
Total Cost: $325.00.

*When signing this form, you as a parent or guardian will be required to work a ONE HOUR MINIMUM in the concession
stand or at the gate before or after your child's game AND also during the weeks of practice. We also need help with
clean-ups. Without the concession stand revenues, we will not have adequate funding to maintain our program. Your
child's coach or a concession stand representative will have sign-up sheets to help you choose a time to fit your
schedule.

SIGNATURE OF PARENT OR GUARDIAN:_________________________________________DATE:________________

Father's Name (or guardian)____________________________________Email address:________________________

Address:_______________________________________________________________________________________

Home Phone:_________________________________________Cell Phone:_________________________________

Employer:____________________________________________Work Phone:________________________________

Mother's Name (or guardian)____________________________________Email address:_______________________

Address (if different):______________________________________________________________________________

Home Phone (if different):_______________________________Cell Phone:__________________________________

Employer:___________________________________________Work Phone:_________________________________

Name, Address, & Phone Number for nearest relative not living with you:______________________________________

______________________________________________________________________________________________

IF YOUR CHILD'S UNIFORM AND EQUIPMENT IS NOT RETURNED:
1. Your child will not receive a trophy.
2. Your child will not be allowed to participate in the next session or any other sports through O.S.Y.C.
3. You, as a parent or guardian, will be responsible for the total cost of the missing items plus any additional fees
necessary to replace the items such as, but not limited to, shipping fees, handling fees, printing fees, etc.

*If you are interested in assisting with a team, then please check here:_________

*Do you have health insurance for your child? Yes__________ No__________