UTAH VALLEY FOOTBALL LEAGUE 2008 SEASON APPLICATION                                   Weight:________________

Please PRINT All Information!  (Application must be completed in full before receiving a uniform.)

Name of Jr. High you will/are attending:   Grade:

PLAYERS Name:   Phone #:

E-MAIL ADDRESS:   Player's Date of Birth (mm/dd/year): 

Player's Home Address:   City:   State:   ZIP:

Parent/Guardian Name:   Cell/Work Phone #:
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 FEES:  
 3rd - 8th grade: $115.00 Cash or Check:_____________________________________
               Jersey: $25.00 (player keeps jersey) Amount:___________________________________________
             TOTAL: $140.00 Check #:__________________________________________
  Name on Check:____________________________________
             9th grade: $150.00 (player returns jersey)  
   
DEPOSIT: Card #:_____________________________  Exp. date ______
             Uniform: $200.00 (will be returned when uniform is Check #:____________________________  Cash: _________
                                          received in good condition)  
             Return within 15 days of last game  

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 PARENT'S CONSENT

  I recognize and acknowledge that the playing of football is a dangerous and potentially harmful sport, and I hereby release said football conference, Provo City Recreation Department, Provo School District, Orem City Recreation Department, Alpine School District, and all agents and participants of the league, whether players, coaches, directors or others involved in any other capacity, from any and all rights, resulting from participation in the football activity, league, or program at any time hereafter, whether during participation of the game activities, practices, traveling or while en route to or from games, practices, or any and all other activity in connection with said football conference.  In addition, I hereby represent that my son/daughter, the above student, is adequately covered by his/her or my own separate insurance, and that any accidents, claims, losses or causes of action shall be resolved separately and pursuant to my own contractual rights under said insurance without rule, subornation, risk, loss or liability whatsoever to said players, coaches, directors or others involved with the football conference.

I hereby give my consent for my son to participate in the athletic program sponsored by the Utah Valley Football League.
I also give my permission for the Utah Valley Football League coaches or representatives to act in my behalf in order to
provide or to seek emergency attention for my child.  In case of an emergency I may be reached by calling the above phone
number or call the following number: .

I am insured by    Policy #

My child's physician is

Medical alert or allergy information

My son/daughter is qualified physically to participate in this sport (a physical examination is recommended).

By signing this form I acknowledge that I have read and agree to the above information. I also verify that the
information I have disclosed on this from is accurate.  And I agree to return all uniform pieces at the last game,
or I forfeit my $200.00 deposit 

Parent or Legal Guardian ________________________________________________  Date ________________________
                                                                                  (Please print then sign form)