Child's Name *

First Name

Last Name

Parent/ Guardians Name *

First Name

Last Name

Phone Number *

(###)

###

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Birth Date *

MM

DD

YYYY

Parental Consent/ Agreement to Participate *

The North Carroll Colts Youth Football Free Youth Clinic is a non-contact football clinic with an emphasis on basic football fundamentals that will include calisthenics, agility drills, coaching position responsibility etc. The Free Cheer Clinic will focus on basic cheer fundamentals that will include calisthenics, cheer techniques, and basic tumbling review, etc. Coaching instructions will be performed by area high school and youth coaches for all children ages 5 to 14 years. I understand the North Carroll Colts Football organization does not provide medical or hospitalization insurance whatsoever. The undersigned hereby waives any and all claims against the North Carroll Colts or any other person affiliated with the North Carroll Colts for injuries sustained while being involved with the Clinic. I hereby state that my child is in good health and is medically cleared to participate in the Clinic. It is my responsibility to notify the clinic director if any reason should develop that my child should not participate. In case of an emergency, I hereby give my permission for a program representative to call 911 and have my child transported to a hospital. I further acknowledge that I have read and fully understood the above mentioned facts and I certify that all answers, to the best of my knowledge, are to true and correct.

I am a legal guardian / parent of the child registering for the clinic. I acknowledge and agree to the above information.