MEDINA YOUTH
FOOTBALL AND CHEERMYFA is a 501 c3 Non-profit Organization
Celebrating over 40 years 2011 Registration Form
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Print and Mail to P.O. Box 1644, Medina, Ohio 44256
One Parent or Legal Guardian must sign the form.
Children of active US Military play for free. Those requesting financial scholarships may write a request on this form or contact a MYFA board member. NO CHILD IS TURNED AWAY.
Forms required later: Child's Birth Certificate, SAP form, Photo, Physical, WYFA Registration Form and Code of Ethics.
The SAP (Sports Activity Permit) Form from the City of Medina is not required for Flag or Cheer.
No refunds after July 31, 2011
Participant / Family Information
Participant's First Name
| Participant's Last Name
| Participant's Nickname
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Participant's Birthdate M/DD/YY
| Age as of 8/1/11
| Name of School in Fall '11
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Grade Level '11
| Estimated Weight (Boys Only)
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Mother/ Guardian's First Name
| Mother/ Guardian's Last Name
| Mother/ Guardian's Email
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Mother/ Guardian's Phone - Home
| Mother/ Guardian's Phone - Work
| Mother/ Guardian's Phone - Cell
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Father/ Guardian's First Name
| Father/ Guardian's Last Name
| Father/ Guardian's Email
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Father/ Guardian's Phone - Home
| Father/ Guardian's Phone - Work
| Father/ Guardian's Phone - Cell
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Is this your first year in MYFA Tackle or Cheer?
| Yes __________
| No __________
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Requested Team Affiliation (if any):
| Colts (Red & White) __________
| Mustangs (Black & Orange) __________
| Either __________
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Participant - Age as of 8/1
| Tackle - Freshman Tackle - B Squad
| 8 years old by (12/31) and less than 105 lbs
| 9 years old and less than 65 lbs
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| | Tackle - Sophomore Tackle - A Squad
| 9 years old and less than 110 lbs
| 10 years old and less than 70 lbs
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| | Tackle - Jr. Varsity Tackle
| 10 years old or less and under 115 lbs
| 11 years old and under 90 lbs
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| | Tackle - Varsity Tackle
| 12 years old or less and under 130 lbs
| 13 years old and under 110 lbs.
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| | Cheer B Squad
| Ages 7,8,9
| Grades 2-3
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| | Cheer A Squad
| Ages 9, 10
| Grades 3-4
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| | Cheer JV Squad
| Ages 10,11
| Grades 4-5
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| | Cheer Varsity Squad
| Ages 10,11,12,13
| Grades 5,6,7,8
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| | Cheer Mascot
| Ages 5,6,7
| Mascots under age 5 are not covered by MYFA Insurance. See Director
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| | Flag | See Link to MYFA/NFL Flag Registration Form
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Fun for All - No Age Limit
___ Head Coach Tackle
| ___ Assistant Coach Tackle
| ___ Team Mom |
___ Chain Gang
| ___ Game Official
| ___ Game Announcer
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___ Field Maintenence
| ___ Program Manager
| ___ Web Site
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___ Cheer Advisor
| ___ Cheer Team Mom/Dad
| ___ Banquet Committee
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___ Parade Committee
| ___ Fundraising Committee
| ___ Director or Board Position
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I/We understand and acknowledge by allowing my/our child to participate in this physical activity that the risk of of injury is present. I/we understand that it is my/our responsibility to provide our own accident insurance and health insurance coverage for my/our child and am fully responsible for any fees related to emergency or non emergency medical treatment(s).
X ___________________________________________________ X_________________________________________________ Date _______________________
