2009 FOOTBALL REGISTRATION FORM NEWTON HIGH SCHOOL'S 3RD ANNUAL SUMMER FOOTBALL CAMP GRADES 4th-8th REGISTRATION FORM
Welcome to Newton Braves Youth Football Online Registration.

The"Newton Braves Youth Football" program is part of the Newton Junior Athletic League. This program is for children ages 5-14, living in the Andover, Green, and Newton sending district.

Steps to Register Online:
1) Fill out this online information form for each child as instructed.
2) An email will be sent to you confirming your registration. The email will contain a printable submission form.
3) IF YOU DID NOT PAY BY CREDIT CARD, TO COMPLETE YOUR REGISTRATION YOU MUST PRINT, SIGN, AND MAIL THE REGISTRATION FORM WITH PAYMENT TO: Newton Braves Youth Football, 21 Field View Rd. Andover NJ 07821
Registrant Information
Name:
FirstLast
Address:
City, State Zip:
Phone:
Email:
School Attending in September 2009:
Day Child was Born:
Month Child was Born:
Year your Child was Born:
Grade Attending Septemeber 2009:
Program Level:
Program Name:
Name of Parents or Guardian Registering Child:
Emergency Contact:
Emergency Contact Phone:
Insurance Company:
Policy #:
Volunteers needed! Let us know if you are interested in::
SPECIAL HEALTH COMMENTS: IFYOUR CHILD HAS HAD ANY SERIOUS INJURY WITHIN THE LAST TWO YEARS OR ANY OTHER PHYSICAL CONDITONS AND/OR MEDICATIONS PLEASE DESCRIBE::
Comments:
Flag Football
$65.00
Flag Football Per Child
Select this option if you are signing up your child
Aug, 1st 2009 - November 25th 2009Flag level will begin practrice about the second/third week in Aug See Coach for Times and # practices per week
Football Tackle all Levels
$95.00
Football Tackle All Levels 1st Child
Select this option if this is the First Child you are signing up for the Tackle program
August, 1st- November 25th 2009Practice in Aug 6:00pm-7:30pm (M,T,W,TH,F) When school starts 6:00pm-7:30pm (See Coach)
$75.00
Football Tackle All Levels 2nd Child
Select this option if this is the Second Child you are signing up for the Tackle program
August, 1st- November 25th 2009Practice in Aug 6:00pm-7:30pm (M,T,W,TH,F) When school starts 6:00pm-7:30pm (See Coach)
$20.00
Fundraiser Buyout
Select this Option if you choose not to participate in any fundraising for the 2009 season
Practice Jersey
$25.00
Practice Jersey with Name and Logo
Sizes Youth Sm, Youth Med, Youth Large, Adult Sm, Adult Med, Adult Large, Adult X-Large Put correct size in Comments Box
Late Charge for Registration after June 30th 2009
$15.00
Late Charge for Registration
Late Charge for All Registrations after June 30th 2009
GENERAL RELEASE:
I herby cetify that my child is in good health and has my permission to participate in the Newton Youth Football/ Newton Junior Athletic League Football program. I also give permission for my child, in the event of an accident, injury, sickness, etc. to be given emergency medical treatment at a local hospital or urgent care facility. I am aware that the Newton Junior Athletic league carries limited medical accident insurance to cover all registered participants and that the applicant's health insurance, if applicable, is the primary insurance coverage.

I understand and agree that the club recommends that each candidate have a physical examination by his or her own personal physician prior to the start of practice.


FUNDRAISER & BUYOUT:
I understand that fundraising is the responsibility of all participants/parents registered in this sport and agree to participate fully or pay the amount of $20.00 to choose not to participate in any fundraising. I also, understand that as a parent of a participant, I will be responsible for working at least on half time home game during the season in the capacity of snack stand volunteer, 50/50 collection or chain gang for football games.

NEWTON YOUTH FOOTBALL/NJAL ATHLETIC LEAGUE COD OF CONDUCT:
The essential elements of character building and ethics in sports are embodied in the concept of sportmanship and six core principles:TRUSTWORHTINESS, RESPECT, RESPONSIBILITY, FAIRNESS, CARING AND GOOD CITIZENSHIP.As the parent of the registered minor, I agree to ensure my son/daughter abides by the rules and guidlines set forth by the coach, the Newton Youth Football/NJAL board or any member of the NJAL in authority and if my son/daughter fails to follow set rules/regulations, I understand he/she will be subject to disciplinary actionthat could include, verbal warning by a coach, official or league representative head, game suspension with an incident report put on file with the Newton Youth Football/NJAL, game forfeiture by an official and season suspension.

Parent:
I hereby agree to ensure all family members and our invited guests:
1) Accept all decisions made by the referees
2) Demonstrate good sportsmanship while being a spectator at the games.
3) Refrain from any actions that may endanger the safety or comfort of the team members, coaches or other spectators.
4) Be a positive role model and watch the game and competition in the sprit in which it was intended, as a recreation sponsored activity for the physical and social development of the team members.

MEDIA RELEASE:
I hereby authorize the Newton Youth Football/Newton Junior Athletic League for my child to appear on the Newton Youth Football web site (www.NewtonYouthFootball.org), on videotape or pictures of games played while in the Newton Youth Football program.

EQUIPMENT AGREEMENT:
I understand that any uniform or equipment issued to my child is the property of the Newton Youth Football/NJAL and I agree t keep said uniform and equipment in good condition and to return at the end of the season. I understand that I will be charged $250 for the cost of replacing any uniform or equipment belonging to the Newton Youth Football/NJAL for failure to return. I am aware that ALL REGISTRATION FEES ARE NON-REFUNDABLE.

I have read and agree to all terms and conditions aboveParent or Guardian Initials for Consent