Youth Football Sign-ups

I hereby authorize the above name child to participate in Potterville Youth Football and Cheer practice and games. I hereby release Potterville Youth Football and Cheer from any liability arising out of said participation whether at play or as a spectator. I understand coaches are all volunteers and have little to no training and are donating their time to my child. I understand there is a risk of injury. In the event of an injury and I cannot be contacted. I give permission for treatment as needed including ambulance transport if necessary. I understand Potterville Youth Football and Cheer has no Liability Insurance being a volunteer run program. I further agree to assume all cost associated with such treatment. No refunds will be given after first practice. If there is enough for a team and you chose to leave after payment has been received no refund will be given. Equipment will not be given until payment has been received. I also understand that my child must have a physical dated after April 15 on this year to participate.

Emergency Contact other than above.