Super Sports Elite Youth Football League Registration Form

(Any falsification may result in the suspension of participation from the program.)

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Choose a Sport
This is to certify that : Participant’s Name
Participant’s Name Participant’s Name First Last
Mother/Guardian Phone: Mother/Guardian Phone: - ### - ### ####
Father/Guardian Phone: Father/Guardian Phone: - ### - ### ####
Address Address
Street Address City State / Province / Region Postal / Zip Code
Family Email Address
School
Birth Date: Birth Date: / MM / DD YYYY
Years of age on July 1, 2024
is physically qualified to participate in the Super Sports Elite (SSSPE) and that we, the parents or guardians, will not hold the administrators of
the SSSPE, the coaches, volunteers, or sponsors responsible for any injury sustained during the scheduled games, practices, or transportation
thereto, or hold the SSSPE, their officials, volunteers or agents, liable for seeking or obtaining aid and assistance, to include hospitalization,
medical aid or ambulance service, for participants who are believed to be injured or hurt
**IN CASE OF EMERGENCY PLEASE CONTACT:
Name Name First Last
Relationship
Phone Phone - ### - ### ####
Name Name First Last
Relationship
Phone Phone - ### - ### ####
Name Name First Last
Relationship
Phone Phone - ### - ### ####
HOSPITAL AUTHORIZATION: Should it be necessary, the coaches and/or officials have the authority to sign the necessary papers
for medical treatment for my child. In case of injury, I prefer my child to be treated by:
Do you a private doctor incase of an emergency?
Doctor
Phone Phone - ### - ### ####
Preferred Hospital:
Insurance Company:
Policy#:
Employer’s Name/Address:
Cost’s: Football - $250.00 Cheerleading $250.00
I _______________________ (Parent/Guardian) have read and understand that Super Sports Elite (SSSPE) has not and does not carry medical insurance for participants. I understand that should it be necessary, any and all medical expenses for my child are my responsibility. PLEASE READ CAREFULLY BEFORE SIGNING I/We consent to our child’s participation in the Super Sports Elite (SSSPE) program. In consideration for permitting our child to participate in the activities conducted by Super Sports Elite (SSSPE), we release, waive, discharge, covenant, and relinquish any and all action or cause of action against the organization, promoters, officials, staff coaches, and/or volunteers for personal injury, death and or property damage occurring to our child as a result of engaging or receiving instruction in the activities conducted by this organization. We further release all officials, officers, promoters, staff, coaches, and/or volunteers from any claim whatsoever on account of first aid, treatment, or services rendered to their child during participation in this organization. We agree to return all equipment, cleaned and in good condition to Super Sports Elite (SSSPE) by the date notified.
► NO CHILD CAN PRACTICE/PLAY FOOTBALL WITHOUT AN UPDATED PHYSICAL ON FILE WITH THE LEAGUE ◄
Print Name:
Signature:
Date Date / MM / DD YYYY
Print Name:
Signature:
Date Date / MM / DD YYYY
Participation in sports involves some risk to its participants. SSPE, through its use of specially adapted rules, regulations, and protective
equipment, helps to minimize these risks. However, participants and their parents or guardian must accept personal and financial responsibility
for the risks associated with these sports. A parent or guardian should assess the medical and physical condition of the child prior to the start of
the season. SSPE provides excess medical insurance only. The plan benefits are payable for covered expenses not covered and payable by any
other plan providing medical expense benefits, including medical trusts. I acknowledge, by signing, that I will provide medical insurance for
my child. I also do not hold the League or its directors/officers liable for medical expenses that may occur.
I understand that the SSPE permits the participant to use the below mentioned equipment at no charge. I agree to maintain and return the
equipment in the same condition as it was issued (except for normal wear and tear). The League reserves the right to determine the status of
said equipment. I also agree that in the event any of the below equipment is damaged, not returned, lost, or stolen, I am held responsible for its
replacement cost. I also understand that if the equipment is not returned by the Equipment Return Date, I am held responsible for the entire
cost of the below-issued equipment.

No refunds will be made after the first day of practice. All fees and birth certificates are due on Equipment Issue Day.
Notes:
Parent or Guardian Signature

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Grade assignment during the season:
Did you participate in the SSPE?

Did you participate in the SSPE? Yes No
If yes, what team?
As a parent would you be interested in
coaching:

As a parent would you be interested in
coaching: Yes No
Each parent is asked to volunteer ___
hours during the season to help create a
successful program.

Each parent is asked to volunteer ___
hours during the season to help create a
successful program. Concession Stand Parking Attendant Parking Attendant

Please choose where you would like to
volunteer.
Total Replacement Cost if Damaged, Not Returned, Lost, or Stolen = $200.00
Jersey $50.00
Shoulder Pad $35.00
Pads (7) $10.00
Helmet w/pads/strap $85.00
Pants $15.00
Belt $5.00

Super Sports Elite Youth Football League Registration Form

Super Sports Elite Youth Football League Registration Form

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This is to certify that : Participant’s Name

**IN CASE OF EMERGENCY PLEASE CONTACT:

HOSPITAL AUTHORIZATION: Should it be necessary, the coaches and/or officials have the authority to sign the necessary papers for medical treatment for my child. In case of injury, I prefer my child to be treated by:

Cost’s: Football - $250.00 Cheerleading $250.00

► NO CHILD CAN PRACTICE/PLAY FOOTBALL WITHOUT AN UPDATED PHYSICAL ON FILE WITH THE LEAGUE ◄

Total Replacement Cost if Damaged, Not Returned, Lost, or Stolen = $200.00

Jersey $50.00 Shoulder Pad $35.00 Pads (7) $10.00

Helmet w/pads/strap $85.00 Pants $15.00 Belt $5.00

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HOSPITAL AUTHORIZATION: Should it be necessary, the coaches and/or officials have the authority to sign the necessary papers
for medical treatment for my child. In case of injury, I prefer my child to be treated by:

Jersey $50.00
Shoulder Pad $35.00
Pads (7) $10.00

Helmet w/pads/strap $85.00
Pants $15.00
Belt $5.00