Chuckie Magee Flag Football & Cheerleading League

Participant Full Name*

Participant Date of Birth*

Participant Age*

Participant Address*

Participant Phone*

Participant Email*

League Participation Type* Please select how the participant would like to participate.

Participant T-Shirt Size*

Parent/Guardian or Support Person Name*

Parent/Guardian or Support Person Relationship*

Parent/Guardian or Support Person Phone*

Parent/Guardian or Support Person Email*

Preferred Method of Communication*

Emergency Contact Name*

Emergency Contact Relationship*

Emergency Contact Phone*

Has the participant participated in flag football before?**

Does the participant have any medical conditions, allergies, medications, or health needs we should know about to support safe participation?*

Are there any mobility, sensory, communication, behavioral, or support needs that would help make this a positive experience?*

Photos and videos may be taken during league activities and used by Chuckie Magee Flag Football & Cheerleading League in social media, marketing materials, publications, websites, newsletters, and fundraising communications. Do you give permission for the participant’s photo and/or video to be used?*

I understand that participation in recreational sports is voluntary and involves some risk. I release the league, organizers, volunteers, and facility partners from liability except in cases of gross negligence or intentional misconduct.*

This league is intended for adults (18+) with disabilities. Disability categories may include, but are not limited to: intellectual/developmental, physical, sensory, neurological, mental health, or other disabilities. I certify that I am (or the participant is) an adult with a disability and understand this program is intended for adults with disabilities.*

I certify that the information provided in this registration form is accurate to the best of my knowledge. I understand the purpose of this program and acknowledge the selections and permissions included in this registration.*

Please indicate who completed this registration:

Participant or Representative Digital Signature *

Participant Registration