Approximate Weight________________ 

 Contact Football Experience______________

Practice Jersey Size________________  

 T-shirt Size (Flag Football)_______________ 

I/We, the parents and or guardian of the above named candidate, hereby give my/our approval to participate in any and all camp activities.  I/We understand that once the above named candidate participates in one camp session, I/We are not entitled to a refund.  I/We give permission for CCYF to release my/our address for football/cheerleading promotions. I/We assume all risk and hazards incidental to such participation, including transportation to and from the activities; and I/we do hereby waive, release, absolve, indemnify and agree to hold harmless CCYF, staff, organizers, sponsors, participants and persons transporting my/our child to and from activities; for any claim arising out of an injury to my/our child, whether the result of negligence or from any other cause, except to the extent and in the amount covered by accident and liability insurance.  I/We understand that the insurance carried by this league covers only the amount that is not paid by my/our carrier.  I/We agree to return upon request the uniform and other equipment issued to my/our child in as good a condition as when issued except for normal wear and tear. 

Allergies (list):________________________________

____________________________________

Serious Medical Conditions (list):________________________________

____________________________________

I/we state that my child is in good health to participate in contact football drills and other associated CCYF camp functions.   I/we hereby grant consent to any and all health care providers designated by:

Chester County Youth Football to provide my child____________________ (name) any necessary medical care as a result of any injury/illness.

This consent includes First Aid and transportation to/from health care providers.