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Player Registration

Preferred Jersey Number 

Players Information

Birth Certificate 

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Player Photo 

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Guardian Information

Emergency Contacts

I consent to my child’s participation in the Junior Pioneer Football program. In consideration for permitting my child to participate in the activities conducted by Junior Pioneer Football, I release, waive, discharge, covenant and relinquish any and all action of cause of action against the organization, promoters, officials, staff coaches, and/or volunteers for personal injury, death, and/or property damage occurring to my child as a result of engaging or receiving instruction n the activities conducted by this organization. I further release all officials, officers, promoters, staff, and/or volunteers from any claim whatsoever on account of first aid, treatment or services rendered to my child during participation in this organization. I agree to return all equipment, cleaned and in good condition to Lebanon Junior Football by the date notified. 

I GIVE PERMISSION FOR MY CHILD TO BE PHOTOGRAPHED AND/OR VIDEOED DURING GAMES, PRACTICES OR ANY LEBANON JUNIOR PIONEER EVENT.

PARENTS SIGNATURE:

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