2024 Tackle Registration

2024 WJFL Registration Form

Number of Players Registering *

Tackle - 1 Player - $200.00

Tackle - 2 Players - $300.00

Please select one below:

Player 1 First and Last Name *

Player 1 School Attending this Fall (2024) *

Player 1 - Fall 2024 Grade

Player 1 - Please select the team you played for last year (2023) *

Player 1 - Height in Inches *

Player 1 - Weight *

Player 2 First and Last Name *

Player 2 School Attending this Fall (2024) *

Player 2 - Fall 2024 Grade

Player 2 - Please select the team you played for last year (2023) *

Player 2 - Height in Inches *

Player 2 - Weight *

Contact Information

Father's Name *

Father's Email *

Father's Phone Number *

Mother's Name *

Mother's Email *

Mother's Phone Number *

Address *

Country

City

State

Zip code

Emergency Contact if Different than Parents

Health Insurance Verification

I the parent or legal guardian of the above named participant verifies that said participant has complete and legitimate health insurance through the carrier listed below, and I understand that Washington Junior Football League does not provide individual health insurance for the above named child.

Please Provide the Name of Health and Accident Insurance Coverage/Company *

Health History

Other - Please Explain

Please Describe Allergies or Reaction to any Medication *

Any Condition Now Requiring Regular Medication? If so, please name condition and medication. *

If so, please name condition and medication.

Any restriction of activity for medical reasons? *

If so, please explain.

Parent Emergency Medical Authorization *

This health history is correct so far as I know, and the person herein described has permission to engage in all prescribed activities, except as noted by me and the physician. In the event I cannot be reached in an emergency, I hereby give permission to the physician, selected by the adult leader in charge, to hospitalize, secure proper anesthesia, or to order injection or surgery for my son/daughter.

Yes, I grant permission.

No, I do not grant permission.

Parental Permission/Agreement To Participate *

I the parent or legal guardian of aforementioned child, do hereby, consent and agree that the above named minor may participate in Washington Junior Football League. It is agreed that the named association or sponsor assumes no legal liability for injuries or other loss as a result of such participation. It is further agreed that this consent shall remain in full force and effect until such time as the undersigned parent or legal guardian shall notify Washington Junior Football League in writing of the abrogation or cancellation of this consent. I do, also hereby agree that all equipment loaned to the above named player shall be returned immediately to Washington Junior Football League upon the completion of the current season or the withdrawal of the above named player from participation in Washington Junior Football League. I do, also hereby agree to accept all provisions outlined in the Four Rivers YFL Constitution and By-Laws, WJFL Constitution and By-Laws and Parent Letter.

Yes, I grant permission.

No, I do not grant permission.

SFBRHS and Washington School District Release *

(This release must be signed for your child to practice or play games on SFBRHS or Washington School District Property) The undersigned, a parent and/or guardian of a participant in Washington Junior Football League Inc., hereby releases, remises, and forever discharges St. Francis Borgia Regional High School and the Washington School District, its agents, successors and assigns, and all other persons, firms or corporations liable, or who might be claimed to be liable, none of whom admit any liability to the undersigned, but all expressly deny any liability from any and all claims, demands, damages, actions, causes of action, or suits of any kind or nature whatsoever, and particularly on account of all damages, known and unknown, both to person or property, which may result in the future from the use of St. Francis Borgia Regional High School and/or Washington School District property. The undersigned hereby declares that the terms of this settlement have been completely read and are fully understood and voluntarily accepted for the purpose of making a full and final compromise adjustment and settlement of any and all future claims, disputed or otherwise, on account of the damages above mentioned. The undersigned further declares and represents that no promise, inducement or agreement not herein expressed has been made to the undersigned, and that the terms hereof are contractual and not a mere recital. THE UNDERSIGNED HAVE READ THE FORERGOING RELEASE AND FULLY UNDERSTAND IT.

Yes, I grant permission.

No, I do not grant permission.

Media/Marketing Permission *

Washington Junior Football League Inc. may throughout the year use your child’s photo in press releases, postings on our website, Facebook, Twitter, promotional brochures, etc. Your child’s name will be listed on a game program and roster posted on the association website. I understand my child’s image may be used on WJFL media Materials.

Yes, I grant permission.

No, I do not grant permission.

Coaching Help *

If you are available or willing to help coach please check the appropriate line below. Coaches are expected to attend any training sessions, comply with all background checks, adhere to all WJFL and Four Rivers YFL guidelines and by-laws and help out at all WJFL events.

I would like to be a head coach at my child's grade level.

I would be willing to help coach my childs' team.

Team Mom

Not Interested

I would like to coach with:

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