Central U.P. Youth Football Parental Release
This must be completed for each player.

Please carefully read the following items.

1. I understand that there is a risk of injury involved in playing tackle football and I hold the Central UP Youth Football League, Inc. harmless should my child be injured during a game or practice.

2. My child is physically healthy and able to participate in the events as a football player.

3. My child’s youth football administration or coaches are aware of any condition such as asthma that my child suffers. It is my responsibility to carry any necessary medication or devices, such as an inhaler. Central UP Youth Football League, Inc. is not responsible to carry or administer any medication.

4. At all times at the site of the events, in case of medical emergency, I hereby authorize any local hospital, doctor or licensed medical personnel, to take what they feel are the correct procedures as an aid to my child’s health and well being. This permission is extended, as necessary, to any Central UP youth football League, Inc. representatives, coaches or volunteers.

5. If I am present and available at the site and time of a medical emergency, I will retain my right to make all necessary decisions concerning medical treatment of my child.

6. I understand that all travel to and from events are not the responsibility of Central UP Youth Football League, Inc., which shall have no financial responsibility to me whatsoever.

7. I understand that my insurance company is the primary coverage should my child be injured. Central UP Youth Football League, Inc., does, however carry a supplemental policy to cover any unpaid medical balance.

8. I, as Parent/Guardian, give permission for my child to participate in all activities organized and operated by the Central U.P. Youth Football organization.

9. By entering my EMAIL ADDRESS and NAME below I agree with above statement and understand that this will be considered as my digital signature.

Email address *
Parent or Guardian's First & Last Name *
Your answer
Players First & Last Name *
Your answer
Players Date of Birth *
Area Playing *
Division *
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service