We the parents, agree to be responsible for the football uniform. If not returned at the end of the season, replacement costs for said uniform will be paid by the signee. CONSENT FOR MEDICAL TREATMENT: As the parent/guardian of the above named player, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb, or well being of my dependent. Last Name : City : Phone : Zip code : A player cannot play more than one year of each division. Birthdate : School : Team Last Year : Address : Tee-Shirt Size :   First Name : Grade Sept of 2010  

 
 


 
 



   
   


On this date    
  I   We, the parents of the above named player of a CDA Jr. Tackle Football team, hereby give our approval for participation in any and all football activities during the current season. We assume all risks and hazards incidental to such participation including transportation to and from the activities; and we do hereby waive, release, absolve,indemnify, and agree to hold harmless the CDA Jr. Tackle Football Association, their organizers, sponsors, supervisors, participants and persons transporting our child, except to the extent and in the amount covered by accident and/or liability insurance held by the local league.
give my consent.

Participants must furnish shoes, practice jersey, and their own pants with pads. CDA Jr. Tackle Football will issue a helmet, game jersey, shoulder- pads, and a mouthpiece. All players must have a physical - Prior to practice. Physicals are valid for 2 seasons.
 












 


Score Board Field Paint Team Mom












Comments       Yes I Agree   Yes I Agree   Yes I Agree           Yes I Agree         CDA Jr. Tackle desires quality-coaching applicants. Are you interested in a coaching/assistant position?
Yes  



Field set-up I would like to opt out of fundrasing this year:
Chain Crew
I would like to be a Sponsor
This option cost $35 extra.
I do hereby agree to play CDA Jr. Tackle Football with any team to which I am assigned for the 2009 season.




Emergency contact Phone :
Emergency contact name :
This is an all volunteer league please indicate area of service you would like to be involved in :
E-Mail Address : Snack bar/concessions  


Mothers Name : Fathers Name :