South Platte Youth Football League  --  Registration Form


Player Name: Grade 2022-23 School Year: 3rd   4th  5th  6th (choose one)
Date of Birth:    
Address: City, State: ,
Phone: Parent/Guardian:
Player Email: Parent/Guardian Email:

Registration Costs:  $120.00.  The cost includes equipment for games and practice, referees, a football jersey that is yours to keep, and $10,000 secondary medical insurance coverage while at practices and games.

Participating child must be present at registration for measurements.
Please bring this registration form and $120.00 registration fee to the Sterling High School-Tiger Alley Entrance in Sterling .  Registrations will be held and accepted at the following times:

* Sunday, June 26th, 2022 from 5:00 pm until 7:00 pm * Saturday, July 9th, 2022 from 11:00 am until 1:00 pm * FINAL REGISTRATION, Sunday July 24th, 2022 from 4:00 pm until 7:00 pm * Late Registrations are $140.00 and absolutely no registrations after Friday July 29th.
* Equipment Checkout - Sunday August 21st, 2022 12:00-2:00 pm 5th and 6th graders, 2:00-4:00 pm all Coaches meeting, 4:00-6:00 pm 3rd and 4th graders. * Games will start on Saturday September 10th.

Participants must be present for weigh in and equipment sizing. Concussion training for Coaches will be held on equipment checkout day. Online Heads Up Tackling training required for each teams head coach. Call contact people listed below for more information.  

Would you coach? (Requires Concussion Training)

Yes  No


Would you assist? (Requires Concussion Training)

Yes  No


Would you help with equipment check in/out?

Yes  No



I consent to have the above-mentioned player participate in the South Platte Youth Football League.  The Participant and his/her parent/guardian bind themselves, their heirs, executors, administrators, and/or assigns to wave and release the South Platte Youth Football League, the coaches, agents, officers, any other sponsoring or non-sponsoring football associations, teams, or with whom the named participant may be participating, from any and all rights to damage for injuries or loss suffered directly or indirectly in training, practice, games and traveling to and from competition.  I hereby accept full responsibility for the behavior and the participation. (On the electronic version of this form, typing your name is as legally binding as signing your signature on the paper version of this document.) For Coaches, concussion training will be held at Coaches meeting on equipment check out day. It is also available online @

Parent/Guardian Signature:


Health/Medical Insurance Co.

Policy Number:

Doctor's Name:

Doctor's Phone:

For more information you may call:
Mike Busmente 520-4354, Mark Bauder 580-1320, Dean Koester 334-2325, or Jim Edwards 522-2541.

For League Use Only
Jersey Size:__________  Pant Size:__________ Weight:__________
Shoulder Pad Size:__________ Helmet Size:__________  


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