2023  Youth Football Fall Registration
Sign in to Google to save your progress. Learn more
Email *
Player FIRST Name *
Player LAST Name *
PLAYER Birth Date *
MM
/
DD
/
YYYY
Player Grade (fall 2023) *
Street Address *
City *
Parent Name: *
Parent Email *
Parent Cell Phone *
Parent Name (other than above)
Parent Email (other than above)
Parent Cell Phone (Other than above)
NEW Player? *
JERSEYS
New this year - 
Jersey will be issued as part of the uniform. Because of the new style of jerseys, we will no longer be able to personalize jerseys. Therefore we will provide jerseys for use. 
Anyone not returning your jersey will be charged $150.00

*we will do our best to get you your number from last year but we can not guarantee*
List 3 choices for numbers 

Medical Questions
Are you allergic to any general medications (aspirin, sulfa, penicillin, etc ) ? *
Are you on any prescription medication on a permanent or semi-permanent basis? IF so, please indicate in the Other Section the name of the medication and why prescribed *
Required
Have you ever had an epileptic seizure or been informed that you might have epilepsy? *
Has a medical doctor ever told you that you were anemic or had sickle cell anemia? *
Do you have or ever had any of the following diseases? (select all that apply) *
Required
Have you ever been "knocked out" or experienced a concussion during the last 3 years? *
Have you ever had an injury to your neck involving nerves, vertebrae, or discs that incapacitated you? *
Have you had a fracture during the past 2 years? *
Have you ever had a shoulder dislocation or other shoulder injuries in the past 2 years? *
Have you ever had surgery to correct a shoulder condition? *
CONCUSSIONS
Waseca Football takes concussions seriously. Our new top of the line helmets will help with concessions, but it still can happen. Trust your coaches if they ask you to be checked out.
What is a concussion?                                                                                                                                                                 You've probably heard the terms "ding" and "bell-ringer." These terms were once used to refer to minor head injuries and thought to be a normal part of sports. There is no such thing as a minor brain injury. Any suspected concussion must be taken seriously. A concussion is caused by a bump, blow, or jolt to the head or body. Basically, any force that is transmitted to the head causes the brain to literally bounce around or twist within the skull, potentially resulting in a concussion. *
RECOGNITION AND MANAGEMENT:                                                                                                                If an athlete exhibits any signs, symptoms, or behaviors that make you suspicious that he or she may have had a concussion, that athlete must be removed from all physical activity, including sports and recreation. Continuing to participate in physical activity after a concussion can lead to worsening concussion symptoms, increased risk for further injury, and even death.                                                                                                                                                               SYMPTIONS REPORTED BY ATHLETE:                                                                                                             • Headache • Nausea • Balance problems or dizziness • Double or fuzzy vision • Sensitivity to light or noise • Feeling sluggish • Feeling foggy or groggy • Concentration or memory problems • Confusion                                                                                                                                                                          SIGNS OBSERVED BY PARENTS, FRIENDS, TEACHERS OR COACHES:                                                         Parents and coaches are not expected to be able to "diagnose" a concussion. That is the role of an appropriate health-care professional. However, you must be aware of the signs, symptoms and behaviors of a possible concussion, and if you suspect that an athlete may have a concussion, then he or she must be immediately removed from all physical activity.• Appears dazed or stunned • Is confused about what to do • Forgets plays • Is unsure of game, score, or opponent • Moves clumsily • Answers questions slowly • Loses consciousness • Shows behavior or personality changes • Can't recall events prior to hit • Can't recall events after hit.                                                                                                                                                                                                                                                   *
WHAT HAPPENS WHEN A COACH SUSPECTS A CONCUSSION?                                                                                      When a coach suspect that a player has a concussion, follow the "Heads Up" 4-step Action Plan                                                                                                     1. Remove the athlete from play.                                                                                                                                  2. Ensure that the athlete is evaluated by an appropriate health-care professional                                                  3. Inform the athlete's parents or guardians about the possible concussion and give them information on concussion                                                                                                                                          4. Keep the athlete out of play the day of the injury and until an appropriate health¬care professional says he or she is symptom-free and gives the okay to return to activity.                                                                     *
COSTS
Bring payment to Equipment Pick Up 
-Registration and Fundraising Fees are required-

$150 per PLAYER registration (required)

$60  Per PLAYER Breakfast Tickets (5) (required) - You may post date to Sept 10

$100 per FAMILY Burger Fry Tickets (10)  (required)  - You may post date to August 15
*
Required
Link to Pick Up Equipment. 
https://www.signupgenius.com/go/30E0F4DAAAD2FA5FC1-waseca1

*
Required
My Player is insured by the parents and has my permission to participate in Youth football 2023. *
Required
Parents Name completing registration *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy