City of Ionia

Recreation Program Registration Form

- YOUTH TACKLE FOOTBALL -

Registration Fee: $90 Per Participant


Parent or Legal Guardian Information

required
required

Participant Information

You may enter up to three (3) participants with this registration form. Information must be completely entered for each participant.


PARTICIPANT ONE (1)


PARTICIPANT TWO (2)


PARTICIPANT THREE (3)


Waiver of Liability

I / We, the parent(s) / gaurdian(s) of participant(s), candidate(s) for a position with the Ionia Youth Football League, hereby give my/our approval to his/her participation in any and all of the League’s activities during the current season. I/We assume all risks and hazards incidental to any such participation, including transportation to and from the activities; and I / we do hereby waive, release, indemnify, and agree to hold harmless the local team, the Ionia Youth Football League and or Mid Michigan Pony Football League, the City of Ionia, Ionia Public Schools, organizers, sponsors, supervisors, participants, and persons transporting my / our child to or from activities from any claim arising out of an injury to my / our child, except to the extent covered by accident or liability insurance. I / We also grant consent to the home team physician to render whatever emergency medical care as he / she may deem necessary in the event of an injury to my / our child. I am letting my child play at his or her own risk of injury including debilitating injury and / or death.
I / We hereby certify that any proof of age, including birth certificate, if requested or required, used in the registration of my / our child is true and correct. I / we fully understand that should otherwise be proved true, all of the games in which my / our child participated will be forfeited, and the child may be subject to team change or suspension, with- out benefit of fee refund(s), the final decision to be made by the Ionia Youth Football Advisory Board.
Further, I / We agree that if my / our child makes the team and is issued team equipment, I / we will be responsible for said equipment as follows: immediate return of all issued equipment upon demand. Further, I / we will pay for (at team cost) any and all equipment lost, destroyed or not returned. Further, I / we agree to furnish my / our child with the prescribed pants, shorts, skirts, helmets, pads, shoes, socks, supporters and / or such equipment as necessary for his / her health and safety, and within the guidelines of League requirements, recommendations and / or approval.
CONSENT FOR MEDICAL TREATMENT
I / We parent(s) / guardian(s) of participant(s), a minor child, hereby voluntarily consent to the administration of such anesthetics and the performance of such operations on said minor child as the anesthetist-in-charge and the surgeon-in-charge, respectively, may deem neces- sary, or advise, when said minor child is admitted to any hospital or clinic for emergency treatment.

“Yes” must be checked

Program Registration Online Payment

Registration Fee: $90 Per Participant

By submitting this form, you are agreeing to pay the registration fee online. If you do NOT have receipt of payment, participants may be dropped from the enrollment of this activity.

“Yes” must be checked

You have completed the Program Registration Form. Please make a note of the total fees due to be paid, and then click the SUBMIT button below. You will be directed to the online payment screen.