Northwestern Youth Football

Early Registration Fee will be $140.00 after June 20th, fee is $175.00.  Please submit separate form for each child.  All information is required. 

If financial assistance is requested, please send an email to northwesternyouthfootball(at)gmail.com.  (Replace (at) with @ symbol).  Formatted this way on this page to prevent spamming)

Please complete and sign the following forms and submit to coach prior to practicing or playing.

Player Name*
Parent/Guardian #1 Name*
Address (Parent/Guardian #1)*
E-mail Parent #1*
Parent/Guardian #1 Phone:*
-
Parent/Guardian #2
Address (Parent/Guardian #2)
E-mail Parent #2
Parent/Guardian #2 Phone:
-
Age on August 1st of This Year:*
Grade this fall:*
School Attending This Fall:*
Medical Concerns: Type (None) if applicable*
Concussion History: Enter (None) if no history of concussions*
Consent To Treat:*

I acknowledge by checking the box above, I, the parent or legal guardian, give my permission for medical personnel to attend to my child (named above) in the event of needing emergency medical help due to an injury during participation in the Northwestern Youth Football League. I also give my permission for Northwestern Youth Football personnel to perform first-aid in the event of an injury.

Release of Responsibility:*

By checking the above box, I, the parent or legal guardian of the above listed child understand and assume all risks that are involved with playing tackle football.  I will not hold Northwestern Youth Football, its directors, coaches, or players responsible for injuries that occur while my child is participating in Northwestern Youth Football. This program is not sponsored by, or affiliated with, the School District of Maple. 

I Am Interested In Volunteering: (Check all that appy)
Registration Fee:*
 $