5th/6th Youth Football Sign Up
If your child is interested in participating on the Junior Vikings 5th/6th Football team this fall, please complete the whole Google Form. The team participates in the New Albany Youth Football League. There will be practices held on campus August-October & games mainly on Sundays either on campus or at other schools. There is a participation fee. Equipment such as pads, pants, & a helmet is provided.

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Email *
Student Full Name: *
Student Grade entering in the fall of 2024: *
Student Date of Birth (MM/DD/YYYY): *
Student Weight (there are weight limits for carrying the football): *
Parent 1 Full Name: *
Parent 2 Full Name: *
Parent 2 Email if they desire to receive communication:
Do you reside in the New Albany-Plain School District? *
Emergency Contact Full Name & Relationship: *
Emergency Contact Number: *
Student Shirt Size: *
Student Pants Size: *
Does the student have any experience with football? *
Does the student have any allergies (environmental or food)? If yes, please list.
Are you as a parent interested in helping coach your child's team? *
Will your student be able to attend the Player Evaluations July 29th - August 1st? *
Youth Sports Waiver/Release: 
I authorize my child or ward to participate in the voluntary Columbus Academy youth sports program.  I release and forever discharge Columbus Academy and its trustees, employees, agents, their heirs, successors and assigns, either jointly or severally, from any and all claims, damages, obligations, causes of action or suits, resulting from bodily injury to my child or ward or damage to or loss of their property arising from participation in this program and any travel related thereto.

To the best of my knowledge, my child or ward is physically fit and in good health.  I understand that all standard safety measures will be taken.  I do not hold Columbus Academy or its staff and volunteers liable for illness or accident.

In case of emergency, if parents or guardians, emergency contact person, or the child’s or ward’s physician cannot be reached by phone, I authorize Columbus Academy to arrange for emergency medical treatment inclusive of surgical intervention for my child or ward, and I agree to assume liability for any medical expenses incurred.

Parent/Guardian Signature:

 *
Waiver/Photograph Release: 
     I authorize Columbus Academy to use photos and/or other likenesses of myself and/or my child or the child for whom I have the legal guardianship for any promotional materials regarding Columbus Academy programs, facilities or services. Such images will not be sold to other parties. Promotional materials bearing these images may be distributed to the public and posted on the Columbus Academy websites and/or social media. Columbus Academy reserves the right to use any photo or likeness for a time period beginning when this form is signed and ending upon written request of participant, parent or legal guardian.
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A copy of your responses will be emailed to the address you provided.
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