This document is a registration form for the Sedalia Youth Football League. It requests the participant's name, birthdate, address, last team played for, grade, division last year, and parent/guardian contact information. It states that a copy of the birth certificate must accompany the form and that prior years' certificates are not kept on file. It provides the registration fees and deadlines, as well as the team age limits. It includes a liability waiver releasing the league from injury claims and allowing medical treatment. The parent must sign to acknowledge responsibility for equipment and replacement costs. Payment and documents should be mailed to the league commissioner at the address provided.

1. Date received: _____________
Received by: ______________
Amt received: _____________
Check # _______ Cash _____
SEDALIA YOUTH FOOTBALL LEAGUE REGISTRATION FORM
Name of participant: Birth date:
Address: City: Zip:
Last team played for: Grade next fall:
Division last year:
Pee Wee Mighty Mite Junior
Parent/Guardian’s Name:
Home phone: Cell phone:
Emergency contact name: Emergency contact phone:
A COPY OF BIRTH CERTIFICATE MUST ACCOMPANY THIS FORM!!
PRIOR YEARS ARE NOT KEPT ON FILE!!
Registration Fees and Deadlines: Team Age Limits:
nd
_____$100 if received prior to July 1 1st – 2 graders no older than 9 yrs old
rd th
3 – 4 graders no older than 11 yrs old
th th
_____$115 after July 1 5 – 6 graders no older than 13 yrs old
th
7 graders no older than 14 yrs old
st
(as of August 31 of the
NO FUNDRAISER OR BUY-OUT OPTION present year)
We/I hereby request that you accept the application enrollment of my child ______________________
in the SYFL, football program. In consideration of your acceptance of the application, we/I hereby
release the League Board from all claims on account of injuries which may be sustained by our/my child
of any such injury. We/I understand that any participant who does not abide by the League rules may be
dismissed with no refund. In the event of illness/injury, we/I hereby give our/my consent for medical
treatment and permission to attending physician to hospitalize, secure proper treatment and order
injection, anesthesia, or surgery. We/I will be responsible for any medical and other charges in
connection with my child’s participation in the SYFL. We/I certify that my/our child is covered by medical
insurance and certify that my/our child is physically capable of participating in the SYFL. I fully
understand that I am responsible for all equipment issued to my child and CAN BE HELD MONETARILY
RESPONSIBLE FOR ITS REPLACEMENT.
Parent/Legal Guardian’s Signature: Date:
Please send payment AND birth certificate to: Sedalia Youth Football League
Attn: Commissioner
P.O. Box 2245
www.sedaliayouthfootball.com Sedalia, MO 65302-2245