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Please select the sport you are signing your up for. *

Name of Child *

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Last

DOB: *

Grade: *

School: *

Primary Mailing Address *

Phone Number *

Email *

Name of Parents or Guardians | Relation *

Name of Parents or Guardians | Relation

Parent/Guardian Emergency Contact Information (please be complete as possible): *

Relationship to Player: *

Illness/Allergies:

Medications:

Special Conditions/Concerns:

Checkboxes

Parental/Guardian Permission and Waiver

Adult Code of Conduct

Rules and Regulations

Parent or Guardian Signature *

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Last

Phone

UTES Youth Football: “Building Indianapolis Communities, One Game at a Time”