Each Coach will you provide you information on their practice schedule.

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1 WELCOME TO JEFFERSONTOWN YOUTH FOOTBALL The Jeffersontown Youth Football exists expressly for the benefit of the youth of the community, their parents, and friends. Its aim is to provide a suitable, environment for the physical expression of those youth; one that allows for the development of the desired characteristics useful to them throughout their lifetime. Sportsmanship, teamwork, fair play, honesty, spirit, and cooperation shall be the goals of this organization. We believe that in team sports, victories are not just achieved on the scoreboard. We judge our success by our ability to impress these values on our young players. Check out the website often. This is updated daily with the latest information Fees 2016 Fees will be $150 for the 1st child, $275 for the 2 children and $375 for 3. These fees are due at the time of Registration. (Senior Ages $50) The JYF: provides all necessary equipment except cleats Volunteer Time (Each family is expected to give 4 hours) $30.OO fee for all Returned Checks NO REFUNDS, if you or your child is not sure please discuss before registering. NO mandatory or guaranteed playing time Each Coach will you provide you information on their practice schedule.

2 Louisville Youth Football League Receipt No. { PHOTO HERE } Jeffersontown Youth Football and Cheer REGISTRATION FORM Program: (FOOTBALL or CHEER) CIRCLE ONE DIVISION FOR MIGHTY MITES (5, 6 & 7 YEARS OLD), PEEWEES (8 &9 YEAR OLDS), JUNIORS (10 &11 YEARS OLD) & SENIORS (12, 13 & 14 YEAR OLDS). **DETERMINED BY AGE OF MAY 1 ST, A PLAYER IS ELIGIBLE TO BE A SENIOR IF HE/SHE IS 14 YEARS OLD BUT DOES NOT TURN 15 YEARS OLD BEFORE 12/1 (Player cannot be a High School Student). MM PW JR SR CHILD S NAME: AGE DOB CHILDS SCHOOL: GRADE ( ) PARENT/GUARDIAN NAME: RELATIONSHIP ADDRESS CITY STATE ZIP: HOME PHONE: WORK CELL: ADDRESS: PLEASE LIST 2 INDIVIDUALS TO CONTACT IN CASE OF EMERGENCY: NAME: RELATIONSHIP: PHONE: NAME: RELATIONSHIP: PHONE: LIST ANY MEDICAL CONDITIONS: CHILDS PHYSICAN PLEASE LIST KNOWN ALLERGIES, ILLNESS OR PHYSICAL LIMITIONS PARTICIPANT RELEASE I,,(please print) do solemnly swear that I am the Parent or legal guardian of and that the above named player/cheerleader was born on / /. I understand that it is a misdemeanor for me to swear falsely and any such action will be prosecuted to the full extent of the law. I understand that the safety of the participant is the first importance to Jeffersontown Youth Football, Louisville Youth Football League and its Cheerleading programs. I understand that in spite of all reasonable precautions, injuries can occur. Football is a collision sport and even the best equipment and training will sometimes not prevent an injury due to the many random factors involved in contact. I also understand that cheer leading has its risks as well. The law requires that parental permission by obtained for operative procedures on minors. I give permission for such transportation, diagnostic, therapeutic and operative procedures and transportation as many are deemed necessary for the participant. I, above said name give permission for the said child to participate in the Louisville Youth Football League and its cheer programs. In no way shall I hold LYFL, JYF, its agents, clusters, employees, referees, coaches and any other persons participating in said league liable for any injury or losses to myself or child while participating in this league and its programs. I fully understand that I am totally financially responsible for any and all equipment issued by JYF & Cheer and to return same promptly upon requested by these Youth Football organizations and Cheerleading programs. PARENT/GUARDIAN SIGNATURE: DATE:

3 Any medical condition the league needs to be aware of: MEDICAL INFORMATION Allergies: Medications I (Print Name), do solemnly swear that I am the parent and/or legal guardian of (print players name), and the named applicant was born on mo day year. I understand that it is a misdemeanor for me to swear falsely and any such action will be prosecuted to full extent of the law. In consideration of my minor child/ward being allowed to participate in any way in the Jeffersontown Youth Football, Inc Program, related events and activities, the undersigned agrees that such participant s likeness may be photographed or videotaped and that such image may be published in an outlet used to promote or publicize the sports program. I further understand that the SAFETY OF THE APPLICANT IS OF FIRST IMPORTANCE to the Jeffersontown Youth Football League. In spite of all reasonable precautions, injuries can occur. In the event of needed professional care, I give my permission for a representative of Jeffersontown Youth Football, Inc. to transport or have my child transported by emergency vehicle to the nearest medical facility and for the staff of that facility to administer treatment. In the event of needed medical care, I agree to be responsible for the bills incurred for such treatment and understand that the Jeffersontown Youth Football, Inc. is not responsible for any medical or drug bills for any accident incurred while participating in this sport. I understand there is no mandatory or guaranteed playing time. I have received a copy of the Parents and Players Code of Conduct. There are absolutely no refunds. I have completed the Jeffersontown Youth Football, Inc Minor Waiver/Release Form Signature

4 JEFFERSONTOWN YOUTH FOOTBALL & CHEERLEADING PARENTS' CODE OF CONDUCT. I will teach my child responsibility I will be sure my child makes every effort to attend practices and games, on time I will be sure my child is picked up from practices and games at their conclusion In the event my child cannot attend a practice or a game, I will make sure my child calls the coach and advises him/her. I understand that unexcused absences from practices and games show a lack of commitment and responsibility and will be dealt with accordingly I will encourage my child to take the time to practice on his/her own to build his/her skills I will teach my child to respect other people I will not use foul language, ridicule or criticize the referee, coaches or other players, by yelling from the sidelines, or by making dramatic arm movements I will tell my child that the official is human and sometimes makes mistakes while controlling the game, but that the referee does not "make or break" the outcome of the game. I will allow the coach to coach the game without interference or suggestions from me, and without comments regarding the officials. I will direct any comments or suggestions to my child's head coach or JYF board member, and I will wait at least 24 hours after a game before doing so. I will not argue with fans from opposing teams I will not shout instructions to players from the sidelines and will let the coach do the coaching from the appropriate side of the field I will not criticize the coach's game decisions afterwards in discussions of the game with my child I will teach my child that good sportsmanship is essential to the game I will applaud a good effort in victory and defeat I will applaud good play by the opposing team and players I will discipline my child for use of foul or inappropriate language, or for engaging in unsportsmanlike conduct I will learn the Player's Code of Conduct and taking advantage of every opportunity to reinforce this code with my child Players CODE OF ETHICS Play this sport for FUN. Practice and work hard to improve my skills. Be on time for practices and games and concentrate on always playing at my best ability. Be a team player and not criticize my teammates. Respect and cooperate with my all my coaches and officials. Play by the rules of the game. Never use foul language or curse. Never "trash-talk" or taunt another player, another team, opposing fans. Never argue with the official's calls or decisions. I understand the conduct expected of me in consideration for participating in the Jeffersontown Youth Football League. My failure to conduct myself in accordance with this Code of Conduct may result in the removal of my child, my family and I from the league. Parent Signature Signature

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