THE WILLOUGHBY FOOTBALL LEAGUE, INC.



PLAYER NAME: ____________________________ BIRTH DATE: ______________________

ADDRESS: ________________________________ WEIGHT: _________________________

CITY: _____________________________________ HOME PHONE: ____________________

SCHOOL:_____________________________________________________________________

MOBILE PHONE: ____________________ PARENT NAME: ____________________________

PARENT EMAIL ADDRESS: ______________________________________________________

NEW PLAYER (Y/N):___ PLAYED LAST YEAR (Y/N):_____ NAME OF LEAGUE / TEAM: ______

BIRTH CERTIFICATE ENCLOSED (Y/N):____ COPY OF BIRTH CERTIFICATE MUST BE ON FILE TO BE ELIGIBLE TO PLAY FOOTBALL.

I, the undersigned parent or legal guardian of ___________________________________, verify that the information given above is correct and give permission for my child to participate in the Mentor Cardinal Youth Football Association, I agree that neither the Coach(s) nor the League will be held liable for any injuries sustained during practices, scrimmages, or scheduled games. I will ensure the return of all football equipment issued to my child by the League, or will pay $200. The completed registration form will include a separate $200 check, post-dated to November 30th. This $200 check is collateral for the football uniform. I will sell "Pick 3" raffle tickets. These are $10 tickets that will be split among the teams. There are 1000 tickets total for the League to sell. Each player will be asked to sell about ten tickets, depending on the league player count. I will sign the parent’s code of conduct document.

X _____________________________________________________________________

(Signature of Parent or Legal Guardian)

Registration Fee(s): ___________ Cash: _________ Check #(s): _________

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MENTOR CARDINAL YOUTH FOOTBALL ASSOCIATION

INSURANCE WAIVER

I, the undersigned parent or legal guardian of __________________________________, in consideration of said child being allowed to participate in the Mentor Cardinal Youth Football Association's activities, hereby waive the inclusion of my child in any medical payments or reimbursement insurance coverage afforded to participants in the League. I hereby represent and agree that I will obtain or keep in force at my own cost and expense, insurance coverage for my child's activities in the League.

X __________________________________________________

(Signature of Parent or Legal Guardian)

__________________________________________________

(Health Care Insurance Provider)

I, the undersigned parent or legal guardian of __________________________________, hereby authorizes emergency medical services, as necessary.

X __________________________________________________

(Signature of Parent or Legal Guardian)

MENTOR CARDINAL YOUTH FOOTBALL ASSOCIATION

Thank you for signing up your child(ren) for participation in the Mentor Cardinal Youth Football Association The strength and success of the football program is dependent upon volunteer(s) in order to operate the game day activities, concession stand and to raise funds for equipment and uniforms.

← Please take the time to sign up for the following volunteer activities (please check in the box):

□ Game day activities: score board operation, announcer, yard marker, first down chains, etc.

□ Concession stand assistance: either before or after your child's game.

□ Coaching assistance (especially the seven year old team)

Volunteer’s Name: __________________________________________________

Home Phone #:______________ Cell Phone #:______________ Work Phone #:______________

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Fill in the registration form completely. New player sign-ups require a non-returnable copy of the child's birth certificate.

2018 registration fees:

$ 135.00 for Mentor residents, $ 150.00 for non-Mentor residents; proof of residency required. If more than 1 child is playing, deduct $5.00 from each registration fee amount.

After June 16, registration

is $150 for Mentor residents, $ 165.00 for non-Mentor residents.

For additional information please call: Ron Wilkinson or Bill Burton @ 440-205-2432

Completed registration form, birth certificate copy and registration fees can be sent to:

Mentor Cardinal Youth Football Association

Player Registration

5791 Birdie Lane

Mentor, OH 44060



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3 Divisions: “A” division: 10 & 11 year olds (cannot be 12 before June 2nd) playing weight: 165lbs *

“B” division: 8 & 9 year olds (cannot be 10 before June 2nd) playing weight: 145lbs *

“C” division: 6½ & 7 year olds (cannot be 8 before June 2nd, but must be 7 by November 1st) playing weight: 125lbs *

*PLEASE NOTE: PLAYING WEIGHT IS WITH FULL EQUIPMENT

Exceptions for “A” and “B” divisions listed below:

To move up a division “early”, the player must have attained the age of 7 on or before August 1st for the “B” division, and 9 for the “A” division.

Players that are 12 years old on or before June 1st and enrolled in the 6th grade are eligible to play in the “A” division.

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