AMERICAN YOUTH FOOTBAL

Participant Forms

REQUIRED FOR REGIONAL AND NATIONAL PARTICIPATION

Participant forms must be presented to the Coach or Team Administrator for inclusion in the team book. Team
books must be presented for compliance verification prior to participation in any American Youth Football, Inc.,
American Youth Cheer dba, Regional, National sanctioned event.

All rostered Participants must complete the following paperwork in order to be allowed to participate in any
American Youth Football, Inc., American Youth Cheer dba, Regional, National sanctioned event.

1. Image Release - MINOR

2. Waiver and Release of Liability - MINOR

3. Emergency Medical Treatment, Consent and Information Form

1.2
4. Medical Clearance Form & resume Participation Form

5. Official Participation Tracking and ID Card & Proof of AGE - (see association official for acceptable
document) NOTE: - All-American Division (grade based) Required Documentation Report Card - Please
HIGHLIGHT Division / Grade attending.

6. Absentee Form (as applicable).

All rostered Participants must receive Medical Clearance in order to be allowed to participate in any American
Youth Football, Inc., American Youth Cheer dba, Regional, National sanctioned event. Please use the following
form if you have not already supplied an acceptable medical clearance to your team.

1
Medical Clearance Form. Participant Medical Clearance will become void in the event of an Injury, Accident,
or Illness attended to by a licensed medical professional. The Resume Participation Medical Clearance must be
signed by the attending medical professional in order for the participant to resume active participation. The
signed form must be presented to the American Youth Football, Inc., American Youth Cheer dba, Regional,
National event official.
2
Resume Participation Medical Clearance Form. Some form of Participant Photo Identification system must
be employed by your Association. If none was used the following forms can substituted, and is preferred for the
American Youth Football, Inc., American Youth Cheer dba, Regional, National sanctioned events.
 AMERICAN YOUTH FOOTBALL

Image Release for Minors

ASSOCIATION NAME -

In consideration of (insert child's name) , my minor child/ward being

allowed to participate in any way, in the American Youth Football, Inc. ("AYF") (dba American Youth Football
and American Youth Cheer,) national championships and any other official AYF events and activities, the
undersigned agrees that American Youth Football Inc., is hereby granted the unrestricted right and permission,
free from approval or review, to copyright and/or use my child's/ward's likeness in all media now or hereafter
known, including but not limited to, pictures and videos of my child which he/she may be included intact or in
part for promotion or other commercial use.

Print Name of Parent/Guardian:

Parent/Guardian Signature:

Date:
 AMERICAN YOUTH FOOTBALL
Waiver and Release of Liability For Minors

ASSOCIATION NAME -

IN CONSIDERATION OF ___________________________________________ , my child/ward,

being allowed to participate in the American Youth Football American Youth Cheer Regional/National Championships,
and or the football and or cheer programs of (association name) ,
the Local Organization, which is a legally distinct and organization not operated or controlled by American Youth
Football, despite its membership with American Youth Football, Inc. the undersigned acknowledges and agrees that:

The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID-19) to my child from
the activities involved in these programs are significant, including the potential for permanent disability and death, and
while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness
do exist; and,

1. FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both
known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASES or others, and assume
full responsibility for my child’s participation; and,
2. I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I
observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will
remove my child from the participation and bring such attention of the nearest official immediately; and,
3. I myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin,
HEREBY RELEASE AND HOLD HARMLESS American Youth Football, Inc.; its directors, officers, officials,
agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners
and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY,
ILLNESS, DISABILITY, DEATH, or loss or damage to person or property incident to my child’s involvement or
participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR
OTHERWISE, to the fullest extent permitted by law.
4. I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of
kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to
my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest
extent permitted by law.
5. I, the parent/guardian, assert that I have explained to my child/ward: the risks of the activity, his/her responsibilities
for adhering to the rules and regulations, and that my child/ward understands this agreement.

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY
UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY
SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Print Name of Parent/Guardian:

Parent/Guardian Signature: Date Signed:

UNDERSTANDING OF RISK
I understand the seriousness of the risks involved in participating in this program, my personal responsibilities for
adhering to rules and regulation, and accept them as a participant.

Print Name of Participant:

Participant’s Signature: Date Signed:

 Emergency Medical Treatment, Consent and Information
The following information will be used in the event that a parent / legal guardian is not available. The purpose of this information is to provide a quick
reference for medical personnel should the need arise. Please fill out this form completely. If a particular question is not applicable write "none", n/a, or
other appropriate comment otherwise none will be assumed. If additional space is needed, please use the back of this form. All information disclosed
here will be treated as confidential. It will be the responsibility of the parent/legal guardian to notify the participants coach and league/event officials if
any information needs to be added, deleted, changed, or updated in any way.

ATHLETE INFORMATION
Athlete's Name: Nick Name: Phone: ( )
Address: City: State: Zip:
PARENT OR GUARDIAN INFORMATION
Father's Name:
Address: City: State: Zip:
Home Phone: ( ) Day Phone: ( ) Email:
Employer:
Mother's Name:
Address: City: State: Zip:
Home Phone: ( ) Day Phone: ( ) Email:
Employer:
Guardian's Name:
Address: City: State: Zip:
Home Phone: ( ) Daytime Phone: ( ) Email:
Employer:
FAMILY MEDICAL INSURANCE
Carrier: Group:
Policy #: Group #:
Policy Holder Name:
Family Physician's Name:
Dr's Address: City: State: Zip:
Phone: ( ) Fax: ( ) Email:
EMERGENCY MEDICAL INFORMATION
Preferred Hospital(s):
EMERGENCY CONTACT: Phone: ( ) Relationship:
Please list any medical conditions (allergies, asthma, etc.) And medications being taken by the participant named
above. Please list any other information you may deem relevant, and helpful to emergency medical personnel: (please
note if no information is given and the words "none" or "n/a" is not filled in then, "none" will be assumed.
Allergies:
Medical Conditions:
Other:

I as evidenced below hereby grant permission for my child/ward

to participate in any and all, (Association name) and, American Youth Football, Inc. program(s), event(s), including
but not limited to, athletic, social and/or fundraising activities. I further consent to the administration of any and all medical
treatment necessary to stabilize and or treat any medical condition or medical emergency to which my child/ward is afflicted.
I understand that this authorization is given prior to the need for medical care, but given in advance to avoid any
unnecessary delay in emergency treatment which the attendant and/or medical professional may deem advisable in the
exercise of their best judgment.

Print Parent/Legal Guardian Name Signature Parent/Legal Guardian Date

 AMERICAN YOUTH FOOTBALL
Medical Clearance Form
ASSOCIATION NAME -

Medical Clearance Form - Must be dated after January 1st of the Current Season

I, as evidenced by my name and signature below, do certify that I am licensed MD and or DO in the
state of and am qualified in determining that:

(Childs Name:) is
physically fit and I have found no medical or observable conditions which would contra-indicate his/her
from participating in youth flag football, tackle football, cheer, dance, step or athletic activities.

I am therefore clearing this individual for athletic participation.

Please Print - or - Use Office Stamp Here:

Signature: Print Name Clearly:

Date: / /
( Must be dated after January 1st, of the Current Season ) Office Address:

PLEASE NOTE: This Medical Clearance is voided by injury, accident, or illness, it will be the
responsibility of the Parent/Legal Guardian to notify the participants Coach and League Officials. It will
also be the responsibility of the Parent / Legal Guardian to obtain WRITTEN permission from his/her
physician (either MD or DO) to resume participation. A "Doctors Resume Participation Medical Clearance
Form" is available from the league or you may have the doctor supply his/her own WRITTEN Clearance
as long as it is on the doctor's official stationary and includes the following statement: "(Participants
Name) is physically fit and I have found no medical or observable conditions which would contra-indicate
him/her from participating in youth flag football, tackle football, cheer, dance, step or athletic activities. I
am therefore clearing this individual for athletic participation.
This statement must be supplied by the physician attending to the injury, accident, or illness.

.
 AMERICAN YOUTH FOOTBALL
Resume Participation Medical Clearance Form
ASSOCIATION NAME -

RESUME PARTICIPATION MEDICAL CLEARANCE FORM IS REQUIRED TO RESUME

PARTICIPATION OF ANY KIND AFTER ORIGINAL MEDICAL CLEARANCE IS VOIDED BY
AN, INJURY, ACCIDENT, OR ILLNESS.

I, as evidenced by my name and signature below, do certify that I am licensed MD or DO in the state of
and am qualified in determining that:
(Childs Name:) is physically fit

and I have found no medical or observable conditions which would contra-indicate him/her from
RESUMING participating in youth flag football, tackle football, cheer, dance, step or athletic activities. I
am therefore clearing this individual for athletic participation.

Please Print - or - Use Office Stamp Here:

Signature: Print Name Clearly:

/ /
Date: Office Address:

NOTE: This Resume Participation Medical Clearance is voided by injury, accident, or illness, and it is be the responsibility of
the Parent/Legal Guardian to notify the participants Coach and League Officials. It is also be the responsibility of the Parent /
Legal Guardian to obtain WRITTEN permission from his/her physician (MD or DO) to resume participation. A new "Doctors
Resume Participation Medical Clearance Form" is available from the league or you may have the doctor supply his/her own
WRITTEN Clearance as long as it is on the doctor's official stationary and includes the following statement: "(Participants
Name) is physically fit and I have found no medical or observable conditions which would contra-indicate him/her from
RESUMING participating in youth flag football, tackle football, cheer , dance, step or athletic activities. I am therefore clearing
this individual for athletic participation.

This statement must be supplied by the physician attending to the injury, accident, or illness.

This form may be modified or substituted to comply with local and/or state laws or due to medical practitioner
regulations.
 AMERICAN YOUTH FOOTBALL
Participation, Tracking and ID Card - All-American Division
ASSOCIATION NAME -
A
S ASSOCIATION NAME
S PLACE PHOTO / DMV / MILITARY ID
O CARD HERE
C DIVISION OF PLAY - TEAM NAME

I PARTICIPANT NAME

A
T
JERSEY #
I Grade AGE (7/31)
O

N
PARTICIPANT PARENT/GUARDIAN NAME

HOME PHONE WORK PHONE CELL PHONE

I, Hereby, With My Signature, Do Certify That The Information Below Has Been Collected And Verified By The Means, As
A Minimum, As Instructed In The AYF National Rulebook and/or Operations Manuel, Current Version.

OFFICIAL PLAYER CERTIFICATION

Conference Verification Signature/STAMP Association Verification Signature/STAMP
LEAGUE USE ONLY

DATE OF BIRTH: Age As of GRADE / AGE PARTICIPANT MEDICAL WAIVER/ EMERGENCY SCHOLASTICS
7 / 31 CERTIFICATION CONTRACT CLEARANCE RELEASE MEDICAL /
CONSENT

Month / Day / Year

GAMGAME DATE PLAYER CHECK CODE GAME DATE PLAYER CHECK CODE

INSTRUCTIONS: PLAYER CHECK Will Enter Date, Verify The Identity, Of Each Participant, Initial Each Participant Card,
CODE: OK = Everything Verified, I = Sick/Injured, A = Absent / Dropped
ALL MUST BE CHECKED IN / VERIFIED PLAYING OR NOT / ENTER DETAIL UNDER CODE
 Participation Contract, Tracking and ID Card - Page 2
Last Name First Name Initial Preferred Name

Street Address City / Town State Zip Code Home Phone

Date Of Birth (M/D/YR) Age as of 7/31 Parent/Guardian First Name Parent/Guardian Last Name

Grade in Fall School in Fall School Phone Home Email Address

Name Of Insurance Carrier Policy #

Medical Insurance (circle one)
YES / NO

Football: Cheer: --CHECK ONE -- Registration Fee: $ Check# Cash:

Association: GRAY AREAS FOR OFFICIAL USE ONLY !!

Division: Team:

Jersey Number Assigned: Equipment / Uniform Issued Returned

PERMISSION TO PARTICIPATE
I acknowledge that I am fully aware of the potential dangers of participation in any sport
and I fully understand that participation in football, cheerleading, dance and/or step may result in SERIOUS INJURIES,
PARALYSIS, PERMANANET DISABILITY AND/OR DEATH. Furthermore, I fully acknowledge and understand that
protective equipment does not prevent all participant injuries. I, the parent/guardian of the above-named participant, do
hereby give my approval for my child/ward to participate, and further assert that I have verified with my child/wards
physician, and in my opinion, my child/ward is physically fit and can participate without limitation in any and all Local,
Regional, National, League/Conference, Association and team/squad activities, including transportation to and from the
activities by a licensed driver.
Parent/Guardian Initial: Player Initial:______________
SCHOLASTIC FITNESS
I am of the opinion that my son/daughter/ward is scholastically fit and would benefit by participation in this program. I
agree to submit a copy of my son/daughter/ ward's last completed grade, end of year/last complete report card or a
written statement of scholastic fitness from the school administration.
Initial:
HELMET WAIVER (for football participants)
We acknowledge, AND WE understand the risks involved in my CHILD/WARD, my playing FOOTBALL, which is a
collision sport; the NOCSAE committee has adopted the following warning to be read by, and signed by, both the
parent/guardian and participant. DO NOT USE THIS HELMET TO BUTT, RAM OR SPEAR AN OPPOSING PLAYER,
THIS IS IN VIOLATION OF FOOTBALL RULES AND CAN RESULT IN SEVERE HEAD, BRAIN OR NECK INJURY,
PARALYSIS OR DEATH AND POSSIBLE INJURY TO YOUR OPPONENT, THERE IS A RISK THAT THESE
INJURIES MAY ALSO OCCUR AS A RESULT OF AN ACCIDENTAL CONTACT WITHOUT INTENT TO BUTT, RAM
OR SPEAR, NO HELMET CAN PREVENT ALL SUCH INJURIES.
Parent/Guardian Initial: Player Initial:
EQUIPMENT UNIFORM RESPONSIBILITY
I assume full responsibility for any and all equipment/uniforms loaned to my child/ward and I agree to promptly return,
upon request, the uniform and other equipment in as good condition as when received except for normal wear and tear.
If I fail to adhere to this policy, I will be responsible for and promptly pay the replacement cost of such equipment.
CODE OF CONDUCT Initial:
The ideology of youth sports including this program is to promote good understanding and fundamental knowledge of the sport. It
is also critical that good sportsmanship including the ability to always conduct oneself in an appropriate manner of positive accord
both on and off the field. It is understood that any incident considered detrimental to the pursuit of this ideology will not be
tolerated. It will be addressed in accordance with the statutes of the association, conference, current national affiliation, state and
local laws, and may result in dismissal from the program and the inability to participate in any future related activities of the
association. this code of conduct applies to all involved with the program including but not limited to, the football players,
cheerleaders, spirit participants, parents and guardians. Initial: ____________

PRINT Parents/Guardian Name: Parents/Guardian Signature: Date Signed:

 AMERICAN YOUTH FOOTBALL
Participation, Tracking and ID Card - National Division
ASSOCIATION NAME -
A
ASSOCIATION NAME
S
S PLACE PHOTO / DMV / MILITARY ID
O DIVISION OF PLAY - TEAM NAME
CARD HERE
C
I PARTICIPANT NAME

T
JERSEY # AGE (7/31) O/L WEIGHT
I
O
N PARTICIPANT PARENT/GUARDIAN NAME

HOME PHONE WORK PHONE CELL PHONE

I, Hereby, With My Signature, Do Certify That The Information Below Has Been Collected And Verified By The Means, As
A Minimum, As Instructed In The AYF National Rulebook and/or Operations Manuel, Current Version.

OFFICIAL PLAYER CERTIFICATION

Conference Verification Signature/STAMP Association Verification Signature/STAMP
LEAGUE USE ONLY

DATE OF BIRTH: Age As of CERTIFICATION PARTICIPANT MEDICAL WAIVER/ EMERGENCY SCHOLASTICS

7/31 WEIGHT CONTRACT CLEARANCE RELEASE MEDICAL /
CONSENT

Month / Day / Year Older/Lighter:

GAME DATE WEIGH MASTER CODE GAME DATE WEIGH MASTER CODE

INSTRUCTIONS: Weigh Master Will Enter Date, Verify The Identity, Weight, Of Each Participant, Initial Each Participant Card,
CODE: OK = Everything Verified, ENTER WEIGHT = Over Weight, I = Sick/Injured, A = Absent / Dropped
ALL MUST BE CHECKED IN / VERIFIED PLAYING OR NOT - IF OVERWEIGHT ENTER THE WEIGHT UNDER CODE
 Participation Contract, Tracking and ID Card - Page 2
Last Name First Name Initial Preferred Name

Street Address City / Town State Zip Code Home Phone

Date Of Birth (M/D/YR) Age as of 7/31 Weight Parent/Guardian First Name Parent/Guardian Last Name

Grade in Fall School in Fall School Phone Home Email Address

Medical Insurance (circle one) Name Of Insurance Carrier Policy #

YES / NO

Football: Cheer: --CHECK ONE -- Registration Fee: $ Check# Cash:

GRAY AREAS FOR OFFICIAL USE ONLY !!

Association: Division: Team:

Jersey Number Assigned: Equipment / Uniform Issued Returned

PERMISSION TO PARTICIPATE
I acknowledge that I am fully aware of the potential dangers of participation in any sport and
I fully understand that participation in football, cheerleading, dance and/or step may result in SERIOUS INJURIES,
PARALYSIS, PERMANANET DISABILITY AND/OR DEATH. Furthermore, I fully acknowledge and understand that
protective equipment does not prevent all participant injuries. I, the parent/guardian of the above-named participant, do
hereby give my approval for my child/ward to participate, and further assert that I have verified with my child/wards
physician, and in my opinion, my child/ward is physically fit and can participate without limitation in any and all Local,
Regional, National, League/Conference, Association and team/squad activities, including transportation to and from the
activities by a licensed driver.
SCHOLASTIC FITNESS Initial:
I am of the opinion that my son/daughter/ward is scholastically fit and would benefit by participation in this program. I
agree to submit a copy of my son/daughter/ ward's last completed grade, end of year/last complete report card or a
written statement of scholastic fitness from the school administration.
Initial:
HELMET WAIVER (for football participants)
We acknowledge, AND WE understand the risks involved in my CHILD/WARD, my playing FOOTBALL, which is a
collision sport; the NOCSAE committee has adopted the following warning to be read by, and signed by, both the
parent/guardian and participant. DO NOT USE THIS HELMET TO BUTT, RAM OR SPEAR AN OPPOSING PLAYER,
THIS IS IN VIOLATION OF FOOTBALL RULES AND CAN RESULT IN SEVERE HEAD, BRAIN OR NECK INJURY,
PARALYSIS OR DEATH AND POSSIBLE INJURY TO YOUR OPPONENT, THERE IS A RISK THAT THESE
INJURIES MAY ALSO OCCUR AS A RESULT OF AN ACCIDENTAL CONTACT WITHOUT INTENT TO BUTT, RAM
OR SPEAR, NO HELMET CAN PREVENT ALL SUCH INJURIES.
Parent/Guardian Initial: Player Initial:
EQUIPMENT UNIFORM RESPONSIBILITY
I assume full responsibility for any and all equipment/uniforms loaned to my child/ward and I agree to promptly return,
upon request, the uniform and other equipment in as good condition as when received except for normal wear and tear.
If I fail to adhere to this policy, I will be responsible for and promptly pay the replacement cost of such equipment.
CODE OF CONDUCT Initial:
The ideology of youth sports including this program is to promote good understanding and fundamental knowledge of the sport. It is
also critical that good sportsmanship including the ability to always conduct oneself in an appropriate manner of positive accord both
on and off the field. It is understood that any incident considered detrimental to the pursuit of this ideology will not be tolerated. It will
be addressed in accordance with the statutes of the association, conference, current national affiliation, state and local laws, and
may result in dismissal from the program and the inability to participate in any future related activities of the association. This code of
conduct applies to all involved with the program including but not limited to, the football players, cheerleaders, spirit participants,
parents and guardians. Initial:________________

PRINT Parents/Guardian Name: Parents/Guardian Signature: Date Signed:

 AMERICAN YOUTH FOOTBALL
Absentee Form
ASSOCIATION NAME -

1) Name of Child:

2) Football Class / Division: [ ] National, [ ] All-American (Check One)

ie: Jr. PeeWee, PeeWee, ..

3) Spirit Class / Division: [ ] Blue Level, [ ] Red Level (Check One)

ie: 10 Under,11 Under, ... [ ] Small (5-17), [ ] Large (18-36) (Check One)
4) Program Type:
ie: Football, Cheer, Dance, Step ...

5) Team Name:
6) Event Affected:
(Check all that apply) Local Event State Event Regional Event National Event Other

7) Reason Unable to Participate (check one):

Medically Related (Attach doctor's note)

Scholastically Related (Attach teacher's note)
Family Obligation (Please explain below)
Other (Please explain below)
Waivered Player (Please Attach Waiver)

8) Explanation:

9) By our signatures below, we attest that the information provided herein is true to the best of
our belief.

Parent/Guardian: Date:

Head Coach: Date:

Association Official: Date:

IMPORTANT MESSAGE FOR THE COACH:

All rostered Participants must be accounted for. This form is to be used for participants that, for whatever reason, will
not participate with their team at the Regional or National event. This form (and any attachments) must be in your
Participant / Roster book at the competition check- in/event site. If Participants are found to have been told to stay
home, bullied, or in any other way discouraged from joining the team in an effort to build a stronger team the Head
Coach and the Association will be subject to suspension and a forfeit of any game played at a Region or National
event.