2018 Superior YMCA Flag Football
This form is used for Roster Creation purposes and also serves as the waiver for participation. PAYMENT ON THE SEPARATE YMCA SYSTEM MUST ALSO TAKE PLACE FOR PARTICIPATION TO BE ALLOWED.
LAST NAME OF CHILD
FIRST NAME OF CHILD
AGE AS OF 9/1/2018
DATE OF BIRTH
Four Corners Elem
Great Lakes Elem
Head Start or other community 4K
Lake Superior Elem
Northern Lights Elem
CHILD's t-shirt size
YOUTH EXTRA SMALL
PARENT(S) ACTIVE EMAIL ADDRESS
Each team is led by volunteer parent/coaches. Are you able to help out your child's team?
YES! I've coached before
YES! But this will be my first time.
NO. I cannot coach at this time.
If YES to previous question: Have you coached youth sports in the past? (if NO to previous question, skip this and next question)
YES- flag football
YES- other sport
COACHES' T-SHIRT SIZE
I hereby give my permission and approval for the above-named child to participate in all Flag Football activities during the 2018 season. I assume all risks and hazards incidental to such participation, and I release the YMCA, supervisors, and coaches from any claim arising from an incident or injury to my child. I also understand that the my child's photo might be used for future promotional efforts and if I object, I must communicate these wishes in an email or in writing to Jon Reimer, the YMCA's Aquatic & Sports Director. By answering this question, this will serve as my digital signature.
YES - I have read the above statement and agree to all it contains.
NO - I have read the above statement but do not agree to its contents. (this will remove your child from this roster)
I will pay ONLINE at
I will pay IN PERSON with Superior YMCA desk staff
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