LEAGUE WAIVER
YMCA PARENT AGREEMENT
1. I hereby certify that my child is in normal health and capable of safe participation
in the youth sports program. I assume all risk(s) and hazards incidental to the conduct
of this program and for the transportation to and from the program. I herby authorize
the YMCA to obtain medical treatment for my child in the event that parent(s) cannot
be reached.
2. I support YMCA Youth Sports philosophy, which is based on participation, fun,
physical fitness and health, skill development, teamwork, fair play, family involvement
and volunteer leadership.
3. I understand that teams are divided by schools and grades and that the YMCA
will try to meet parent requests, but all requests may not be granted.
4. The YMCA has provided me with concussion awareness and head injury information.
I have read and understand what a concussion is and what the symptoms are.
I understand it is my responsibility to seek medical treatment if a suspected concussion
is reported to me and I need written clearance from an appropriate medical provider
to return my child to practice or play games.
Signature of Parent or Guardian
Date
PARENT REMINDERS
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Teams and schedules are created right up to the coaches meetings.
Please plan on using the anticipated schedule below.
After our coaches meetings September 8 and 9, your child’s coach will
contact you via phone or email.
I will send an email by Friday, September 11 with schedules and
concussion forms to print off for the season. Please make sure we have
your correct email since most of our communication is through this.
Thank you.
ANTICIPATED SCHEDULE
Based off of last year’s schedule:
4-5k will play from 8:15 AM—9:30 AM
1-2 Grade will play from 9:45 AM—11:00 AM
3-4 Grade will play from 11:15 AM—12:30 PM
Detach registration form and keep remaining half
of detailed information for your records.
FUN, FITNESS
AND FAIR
PLAY
FALL FLAG FOOTBALL
NEENAH-MENASHA YMCA
Saturdays
September 12-October 31
Co-ed League Grades 4K-4 (2015-16 School Year)
Games are played at Shattuck Middle School.
Registration begins: June 1, 2015
Registration closes: August 23, 2015
Our Mission: To put Christian principles into practice by promoting youth, adult and family activities
that build a healthy spirit, mind and body for all.
LEAGUE INFORMATION
This league will give kids in 4K through 4th grade the opportunity
to play flag football in the fall. All players participate in every
game. We emphasize fun, fitness, skill development, fair play and
family involvement. A short practice will be followed by a game each
week. The goal of the YMCA is to provide participants a great place
to learn football while having fun! The YMCA staff also run “Team
Huddles” each week to talk about the four core values of the YMCA:
Respect, Responsibility, Caring and Honesty.
Every player will receive a flag football jersey if registered
before the deadline!
The Fall Flag Football Season will run for eight weeks on Saturdays
at Shattuck Middle School from September 12 - October 31, 2015.
All players will be contacted a few days prior to the first game
by a coach with information on team name and game time. Game
times will depend on registration numbers. See back for more info.
Register at the Neenah-Menasha YMCA Member Services Desk.
The completed form as well as payment are required to register.
Online registration is also available. Be sure to first complete
the form online and then click to complete the payment section.
Phone, fax and mail registrations are NOT allowed.
Fox Cities YMCA Family Member:
YMCA Youth Member:
General Public:
$10
$39
$67
After August 23, 2015, an extra $10 late registration fee will be charged
and registrations will only be taken if space is still available.
Space is limited for each grade level!
Volunteer Parent Coaches Needed!
Parent volunteer coaches play a big role in making our programs
successful. If you would like to help coach your child’s team, please
sign your name on the registration form.
The coaches meetings are on Tuesday, Sept. 8, 2015 at 6:30 p.m.
and Wednesday, Sept. 9, 2015 at noon.
We truly appreciate the help from all of our volunteer coaches!
If you have any questions, please contact Randy Pelischek, Sports &
Recreation Director, at 886-2104 or [email protected]
YMCA FALL FLAG
FOOTBALL SIGN-UP FORM
Grade: (circle) 4K
K
1
2
3
4
Boy / Girl
Player’s Name: ______________________________________________________
Address: ____________________________________ City: __________________
DOB: _____/_____/_____ School: _____________________________________
Parent name(s): ____________________________________________________
Phone: __________________________(#1) ____________________________ (#2)
Email: (Important for sending out information) ___________________________________
Jersey Size:
Youth: S (6-8) M (10-12) L (14-16) Adult: S
M
(We will make every effort possible to give your child the jersey size that
is requested, but this is not always possible based on ordering deadlines.)
If your child desires to be on the same team as a friend, please
write his/her name on the line below. Note that teams are put
together primarily by schools, so not all friend requests may be
possible.
One friend’s name: _______________________________________________________
Register at:
Neenah-Menasha YMCA
110 W. North Water St.
Neenah, WI 54956
Fox Cities YMCA Family Member: $10
YMCA Youth Member: $39
General Public: $67
NOTE: $10 Late Fee if registered after Aug. 23, 2015
Yes, I am interested in coaching.
Name: ______________________________________________________________________
Best phone number to reach you: __________________________________
Email Address: __________________________________________________________
(most information will be communicated through email)
Circle one: Head or Assistant or Either
Any Coach’s Requests: ________________________________________________
L