5 & 6 YEAR OLD SUMMER FLAG FOOTBALL FLYER AND REGISTRATION FORM

2017 Knox County Jr. Football

Ages 5 & 6 Summer Flag League Signups
In addition to our tackle league, a summer flag football league will be offered for ages
5&6. Games will begin in July and end in August before tackle season starts.
Applications can be picked up at Sonnys Sporting Goods and Hinkle Insurance
Please return applications and fees to Sonnys Sporting Goods or Hinkle Insurance.
The Price for Flag Football is:
- $35.00

The Birth Date cut off is age as of July 31st, 2017

Practices will be held at the Knox County Jr Football Field next to the Thompson RV Park in Barbourville.
The games will be played on Saturdays at the Knox County Middle School football field.
Any player who wishes to play in the tackle league after the flag season ends will have the signup fee for flag
applied to the tackle signup fee.
Facebook Fan Page: https://www.facebook.com/knoxcojrfootballfanpage/

GO PANTHERS!

REGISTRATION FORM IS ON THE BACK ->

5 & 6 YEAR OLD SUMMER FLAG FOOTBALL FLYER AND REGISTRATION FORM
2017 KNOX COUNTY JUNIOR FOOTBALL
REGISTRATION, EMERGENCY INFORMATION & CONSENT FORM
**(ONE FORM FILLED OUT FOR EACH ATHLETE) **
REGISTRATION COST IS:
- $35 *Registration cost is due when application is turned in.*

Athletes Name ______________________________________DOB___________ Shirt Size________

Athletes School and Grade____________________________ AGE as of 07/31/2017______________
Parent/Guardian Name_________________________________________________________________
Physical Address_____________________________________________________________________
Employer & Address__________________________________________________________________
Home Phone_________________ Cell Phone_______________ Email__________________________
Family Medical Insurance
Carrier______________________________________ Group ___________________________
Policy Number____________________________ Group Number_________________________
ID Number_________________________________
Participant Physician Name____________________________________________________________
Address____________________________________________________________________________
Phone Number_______________________ Emergency Contact Number________________________
Allergies (list): ______________________________________________________________________
Serious Medical Conditions_____________________________________________________________

I /We hereby grant consent to any and all health care providers designated by the Knox County Junior Football League to provide my
child any and all necessary medical care as a result of any and all injury / illness incurred in practice or games.

I do hereby agree that I have read, understand, and agree to abide by the information and rules contained in the accompanying
information packet, as well as any other program and team rules that I may be advised of in the future.

I have read, understand, and agree to all terms and conditions of the accompanying Registration Form, Media / Internet Photo Release
Form, the Emergency Information and Consent Form, and the Parent Volunteer Form.

I agree to provide the Knox County Junior Football League with all necessary information that they may need or deem necessary
concerning my participating child, and I further agree to fully and completely fill out and turn in all forms required by the Knox
County Junior Football League prior to my child participating.

I agree that any devices or medicines required by my child are to be administered by the parent / guardian only. I agree to make the
coach for the team aware of any health problem and am responsible for providing all necessary administration of medications and
devices. I further agree that it has been strongly recommended to me that my child have physical examination performed by a medical
professional before participating.

I agree to pay in full, all necessary program costs and fees prior to my child participating.

I understand that by registering the above named child in the Knox County Junior Football League, I assume complete risk of any
health related issues.

The jersey, flags and 1 mouthpiece are included with the registration fee. All other clothing needed (shorts, socks, cleats, etc.) will be
the responsibility of the parent/guardian. Flag fee will be applied to tackle fee if player decides to play on tackle team also.

Parent/guardian signature _________________________________Date__________

Please turn in applications to Sonnys Sporting Goods or Hinkle Insurance.