East Aiken Chargers Football Registration Form
AikenCounty Youth Football League
Registration Fee: $90.00 (Includes Purple Socks) (Must be paid on or before August 18 , 2016) Absolutely, No Refunds
No game jersey will be issued, unless full amount is paid, and jersey are issued on a first come, first serve basis.
Child’s Name: ______Birthdate: ______Age ______
School:______Years of Football: ______Phone #: ______Grade: ______
Address:______City:______Zip: ______
Parent/Guardian: ______Must be best contact number: ______
Emergency Contact:______Must be best contact number: ______
Does any medication need to be obtained during games/practices? Yes or No
(Allergies - Asthma - Apex Pen)
Division:Circle one, please.
III (Ages 7-8)
II ( Ages 9-10)
I (Ages 11-12)
**Child must be his age appropriate level by June 1, 2016**
I, ______, parent/guardian of ______do hereby agree and consent to his participation during the 2016Aiken County Youth Football League (ACYF) season. I hereby release ACYF and its representatives for any and all claims for damage for personal injuries, diseases, or death resulting from any child from participation in ACYF activities. This consent and waiver is given upon express conditions that customary insurance for accidents, hospitalizations, covering football activities will be maintained and that claims under such insurance will not be affected by the release. I understand that I will be responsible for the replacement cost ($300) for any equipment not returned at the end of the season. I understand that my child’s behavior must be appropriate when being involved with the ACYF Program. I hereby understand and consent that if these actions will not be followed, my child will be release from being a participant in the ACYF Program.
Do not to enter through the exit way. Aiken Country Sheriff will fine individual $250.00. EAC will not be responsible for this fine. Parents/Guardiansare to park in the parking lot only. No parents are allowed on the practice or game field.
Signature of Parent or Guardian______Date ______
(OFFICE USE ONLY – DO NOT WRITE BELOW LINE)
Name______Total Paid $______Jersey #______
Receipt #______Check#______CC______Cash______Partial Payment______
Fees consist of the following
You are to keep this sheet!
Football Equipment
- A Loaned and Practice Jersey/ Game Jersey
- Practice and Game Pants
- Pads
- Helmet
PLEASE DO NOT WEAR YOUR GAME PANTS TO PRACTICE
Fee includes:
Banquet
Trophy
Football Equipment
Game Mementos
Not Included
Mouthpieces Can be purchased from EAC or at any sporting goods store MUST NOT BE CLEAR
Your child will need the following
1 Copy of Birth Certificate if they are NEW FOOTBALL PLAYERS OF EAC by August 18, required by Aiken County Youth Football League (ACYFL)
Football Cleats no metal cleats at Kick Off, September 10.
Extra Mouthpieces (Sanitary purpose, they chew them, and lose the mouthpiece)
The EAC home concessions are our fundraiser.
All games gate fee is $3.00 adult/$2.00 for students.
Please consider helping with all home games EAC has concession and we definitely can use the help.
Questions or concerns please contact Victoria Patterson/803-640-2209.
Head Coaches Division III-7-8- Coach Ricky
Division II- 10-11 Coach Tim
Division I-11-12 Coach Michael