2015 FALL SEASON FOOTBALL and CHEER

Join Black Hills Youth Football and Cheer League TODAY
Open to all kids Grades 1st thru 8th for football players and cheerleaders
2015 FALL SEASON FOOTBALL and CHEER
On regulation field with announcers, music and cheerleaders
Sign up on-line at
Http://bhyfl.leag1.com
Or for questions contact us at (605) 791-3381
Required Documents COPIES ONLY
(DO NOT MAIL -give to team mom)
____Birth Certificate
____Wallet-sized photo
____Participant Code of Conduct
____Parent Code of Conduct
____Medical Clearance from 2015
____ a 2014 Report card
Received Date Stamp
2015 BHYFL Registration
Please mail Registration form and fees to: “BHYFL 2015”
Tackle
football
Mitey Mite (1/2nd grade
– 3rd grade older/lighter)
Cheer
Jr Pee (3/4th grade –
5th grade older/lighter)
New Registrant: Football $210
PO Box 999 Box Elder, SD 57719
Pee Wee (5/6th grade –
7th grade older/lighter)
605-791-3381
Senior Pee Wee (7/8th grade
– 9th grade older/lighter)
Returning Player registration $195
$85 special rate for
7th,8th or 9th graders!
ALL Cheer $90
Plus uniform which each team/cheerleader gets to keep!
WEIGHT AT REGISTRATION (Football)
Amt Paid __________ Check # ___________ (All returned checks are assessed a $35.00 fee)
All registrants must be paid in full at registration.
*Medical clearance must be submitted before practice begins or THE PARTICIPANT CANNOT PRACTICE FOOTBALL OR CHEER.
Student Athlete’s (Name must match birth certificate exactly) LAST NAME
2014 Division/Team:
Is Parent a coach or team mom?
FIRST NAME
Siblings and ages in program?
PHYSICAL ADDRESS
HOME PHONE (
CITY
)
BIRTH DATE
MIDDLE SCHOOL DISTRICT:
*AGE AS OF 11/15/15
ZIP
*School Grade as of fall - 2015
REFERRING ORGANIZATION/PERSON:
*HIGH SCHOOL DISTRICT
CURRENT SCHOOL ATTENDING
EMERGENCY CONTACT
RELATION
FATHER/GUARDIAN
Primary
NAME
ADDRESS (if different)
ADDRESS (if different)
CITY, ZIP
CITY, ZIP
PHONE ( )
PHONE ( )
CELL ( )
E-MAIL (mandatory) PLEASE PRINT VERY CLEARLY
PHONE (cell )
PHONE (home)
MOTHER/GUARDIAN
NAME
BUS PH ( )
MIDDLE NAME
BUS PH ( )
Primary
CELL ( )
E-MAIL (mandatory) PLEASE PRINT VERY CLEARLY
PARENTAL CONSENT: PLEASE READ AND SIGN: APPLICATION MUST HAVE AT LEAST ONE PARENT/GUARDIAN SIGNATURE
I/WE, the Parents/Guardians of the above named candidate for a position on any of the BHYFL Youth Football/Cheer teams, hereby give MY/OUR approval to his/her
participation in any and all BHYFL Youth Football/Cheer activities during the current year. I/WE assume all risks and hazards incidental to such participation including
transportation to and from such activities, and I/WE do hereby waive release, absolve, indemnify and agree to hold harmless the BHYFL Youth Football League and its
Associations, the sponsors, supervisors, participants, employees, volunteers and persons transporting MY/OUR child to and from activities for any claim arising out of
injury to MY/OUR child. I/WE and participant agree to abide by the BHYFL Rules of Conduct. I/We give the BHYFL President/Commissioner or his/her designee
permission to verify our child’s age if needed by the use of our child’s school records. The BHYFL reserves the right to refuse to accept ANYONE or to remove ANYONE
from the program at anytime as the BHYFL sees fit so as to preserve the safety, integrity and character of the BHYFL and its’ participants. All involved with the BHYFL in
any capacity must obey the Codes of Conduct as set forth by the BHYFL whether they have received and or signed said code of conduct or not. (it is posted on our website)
PARENTAL MEDICAL TREATMENT AUTHORIZATION: In the event of injury to MY/OUR child, I/WE hereby grant authority to present or qualified personnel to
render such medical treatment as said personnel deems necessary under the circumstances.
PARENT/PARTICIPANT RULES OF CONDUCT: I/WE and MY/OUR child agree to abide by the Rules of Conduct and understand the possible consequences of violating the
Rules of Conduct. It IS possible my child may NOT be able to play this season, due to lack of registration in his/her age division. In that case All paid monies will be refunded if
approved. ANY Approved refunds will be refunded at the end of the current season. Code of conducts can be found at www.BlackHillsYouthFootball.com
EQUIPMENT LIABILITY: Parent/Guardians are responsible for return of all equipment and uniforms, clean and in good condition. You, the Parent/Guardian will be
responsible for reimbursement to the league for any cost of lost or excessively damaged equipment or uniforms.
*Failure to return all issued equipment could result in criminal prosecution for Failure to Return Rental property.
WEB SITE PICTURES: I/WE give permission to have my child’s picture on the BHYFL web site, any association ID card, film, or advertisement literature.
Note: If you have any questions, please contact us at 605-791-3381 OR
BHYFLsec@yahoo.com
I/WE have read the above and agree with and understand the policies set forth above. ALL REGISTRATION FEES ARE NONREFUNDABLE
X _________________________________________________________________ X__________________________________________________________________
(Father/Legal Guardian Signature)
(Date)
(Mother/Legal Guardian Signature)
(Date)
FOR LEAGUE USE ONLY
TEAM ASSIGNMENT: _______________________________ DIVISION: _____________________________ MED RELEASE ______ PHOTO ______ BIRTH CERT. ______