{"id":18069,"date":"2025-04-16T13:21:18","date_gmt":"2025-04-16T18:21:18","guid":{"rendered":"http:\/\/www.wjfl.org\/?page_id=18069"},"modified":"2026-05-04T08:56:28","modified_gmt":"2026-05-04T13:56:28","slug":"2025-fall-flag-registration","status":"publish","type":"page","link":"http:\/\/www.wjfl.org\/index.php\/2025-fall-flag-registration\/","title":{"rendered":"2026 Fall Flag Registration"},"content":{"rendered":"<form method=\"post\" enctype=\"multipart\/form-data\" id=\"vfbp-form-27\" class=\"vfbp-form\"><div style=\"display:none;\"><label for=\"vfbp-EMAIL-AN8fuQyoDLXem\">If you are human, leave this field blank.<\/label><input size=\"25\" autocomplete=\"off\" type=\"text\" name=\"vfbp-EMAIL-AN8fuQyoDLXem\" value=\"\" id=\"\"><\/div><input type=\"hidden\" name=\"_vfb-timestamp-27\" value=\"1777900372\" id=\"\"><input type=\"hidden\" name=\"_vfb-form-id\" value=\"27\" id=\"\"><div id=\"vfbp-running-total-box\"><div id=\"vfbp-running-total\"><\/div><\/div><div class=\"vfb-form-group vfb-col-12\"><div><div class=\"\">2026 WJFL Fall Flag Registration Form<\/div><\/div><\/div><div class=\"vfb-col-12 vfb-fieldType-heading\" id=\"vfbField679\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-select\" id=\"vfbField680\"><label for=\"vfb-field-680\" class=\"vfb-control-label\">How many players will be registering?   <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-form-group\"><select id=\"vfb-field-680\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" name=\"vfb-field-680\"><option value=\"1\">1<\/option><option value=\"2\">2<\/option><option value=\"3\">3<\/option><\/select><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-name\" id=\"vfbField681\"><div class=\"vfb-form-group\"><label for=\"vfb-field-681\" class=\"vfb-control-label\">Player  1 First and Last Name <span class=\"vfb-required-asterisk\">*<\/span><\/label><div class=\"vfb-name-block\"><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-681-first\" class=\"vfb-form-control vfb-namepart-first\" placeholder=\"First\" required=\"required\" type=\"text\" name=\"vfb-field-681[first]\"><\/div><\/div><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-681-last\" class=\"vfb-form-control vfb-namepart-last\" placeholder=\"Last\" required=\"required\" type=\"text\" name=\"vfb-field-681[last]\"><\/div><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField682\"><div class=\"vfb-form-group\"><label for=\"vfb-field-682\" class=\"vfb-control-label\">Player 1 - 2026-27 School Year Grade <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-682\" class=\"vfb-form-control\" placeholder=\"K, 1, 2\" required=\"required\" type=\"text\" name=\"vfb-field-682\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-name\" id=\"vfbField683\"><div class=\"vfb-form-group\"><label for=\"vfb-field-683\" class=\"vfb-control-label\">Player  2 First and Last Name<\/label><div class=\"vfb-name-block\"><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-683-first\" class=\"vfb-form-control vfb-namepart-first\" placeholder=\"First\" type=\"text\" name=\"vfb-field-683[first]\"><\/div><\/div><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-683-last\" class=\"vfb-form-control vfb-namepart-last\" placeholder=\"Last\" type=\"text\" name=\"vfb-field-683[last]\"><\/div><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField684\"><div class=\"vfb-form-group\"><label for=\"vfb-field-684\" class=\"vfb-control-label\">Player 2 - 2026-27 School Year Grade<\/label><div><input id=\"vfb-field-684\" class=\"vfb-form-control\" placeholder=\"K,1,2\" type=\"text\" name=\"vfb-field-684\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-name\" id=\"vfbField685\"><div class=\"vfb-form-group\"><label for=\"vfb-field-685\" class=\"vfb-control-label\">Player  3 First and Last Name<\/label><div class=\"vfb-name-block\"><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-685-first\" class=\"vfb-form-control vfb-namepart-first\" placeholder=\"First\" type=\"text\" name=\"vfb-field-685[first]\"><\/div><\/div><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-685-last\" class=\"vfb-form-control vfb-namepart-last\" placeholder=\"Last\" type=\"text\" name=\"vfb-field-685[last]\"><\/div><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField686\"><div class=\"vfb-form-group\"><label for=\"vfb-field-686\" class=\"vfb-control-label\">Player 3 - 2026-27 School Year Grade<\/label><div><input id=\"vfb-field-686\" class=\"vfb-form-control\" placeholder=\"K,1,2\" type=\"text\" name=\"vfb-field-686\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-form-group vfb-col-12\"><div><div class=\"\"><\/div><span class=\"vfb-help-block\"><strong><span style=\"color: #3366ff;\">Contact Information<\/span><\/strong><\/span><\/div><\/div><div class=\"vfb-col-12 vfb-fieldType-heading\" id=\"vfbField687\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-name\" id=\"vfbField688\"><div class=\"vfb-form-group\"><label for=\"vfb-field-688\" class=\"vfb-control-label\">Father's Name <span class=\"vfb-required-asterisk\">*<\/span><\/label><div class=\"vfb-name-block\"><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-688-first\" class=\"vfb-form-control vfb-namepart-first\" placeholder=\"First\" required=\"required\" type=\"text\" name=\"vfb-field-688[first]\"><\/div><\/div><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-688-last\" class=\"vfb-form-control vfb-namepart-last\" placeholder=\"Last\" required=\"required\" type=\"text\" name=\"vfb-field-688[last]\"><\/div><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField689\"><div class=\"vfb-form-group\"><label for=\"vfb-field-689\" class=\"vfb-control-label\">Father's Email <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-689\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"email\" name=\"vfb-field-689\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-phone\" id=\"vfbField690\"><div class=\"vfb-form-group\"><label for=\"vfb-field-690\" class=\"vfb-control-label\">Father's Phone Number <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-690\" class=\"vfb-form-control vfb-intl-phone\" placeholder=\"\" required=\"required\" data-default-country=\"us\" data-number-type=\"MOBILE\" data-hide-flags=\"1\" data-national-mode=\"1\" data-auto-hide-dial-code=\"1\" type=\"tel\" name=\"vfb-field-690\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-name\" id=\"vfbField691\"><div class=\"vfb-form-group\"><label for=\"vfb-field-691\" class=\"vfb-control-label\">Mother's Name <span class=\"vfb-required-asterisk\">*<\/span><\/label><div class=\"vfb-name-block\"><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-691-first\" class=\"vfb-form-control vfb-namepart-first\" placeholder=\"First\" required=\"required\" type=\"text\" name=\"vfb-field-691[first]\"><\/div><\/div><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-691-last\" class=\"vfb-form-control vfb-namepart-last\" placeholder=\"Last\" required=\"required\" type=\"text\" name=\"vfb-field-691[last]\"><\/div><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-email\" id=\"vfbField692\"><div class=\"vfb-form-group\"><label for=\"vfb-field-692\" class=\"vfb-control-label\">Mother's Email <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-692\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"email\" name=\"vfb-field-692\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-phone\" id=\"vfbField693\"><div class=\"vfb-form-group\"><label for=\"vfb-field-693\" class=\"vfb-control-label\">Mother's Phone Number <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-693\" class=\"vfb-form-control vfb-intl-phone\" placeholder=\"\" required=\"required\" data-default-country=\"us\" data-number-type=\"MOBILE\" data-hide-flags=\"1\" data-national-mode=\"1\" data-auto-hide-dial-code=\"1\" type=\"tel\" name=\"vfb-field-693\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-address\" id=\"vfbField694\"><div class=\"vfb-form-group\"><label for=\"vfb-field-694\" class=\"vfb-control-label\">Address <span class=\"vfb-required-asterisk\">*<\/span><\/label><div class=\"vfb-address-block\" id=\"vfb-field-694\"><div class=\"vfb-form-group\" style=\"\"><input id=\"vfb-field-694-address-1\" class=\"vfb-form-control vfb-addresspart-address-1\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-694[address-1]\"><\/div><div class=\"vfb-form-group\" style=\"display:none;\"><label for=\"vfb-field-694-country\" class=\"vfb-address-label\">Country<\/label><select id=\"vfb-field-694-country\" class=\"vfb-form-control vfb-addresspart-country\" placeholder=\"\" required=\"required\" name=\"vfb-field-694[country]\"><option value=\"US\" selected='selected'>United States (US)<\/option><option value=\"GB\">United Kingdom (UK)<\/option><option value=\"CA\">Canada<\/option><option value=\"AU\">Australia<\/option><option value=\"\">---<\/option><option value=\"AF\">Afghanistan<\/option><option value=\"AX\">&#197;land Islands<\/option><option value=\"AL\">Albania<\/option><option value=\"DZ\">Algeria<\/option><option value=\"AD\">Andorra<\/option><option value=\"AO\">Angola<\/option><option value=\"AI\">Anguilla<\/option><option value=\"AQ\">Antarctica<\/option><option value=\"AG\">Antigua and Barbuda<\/option><option value=\"AR\">Argentina<\/option><option value=\"AM\">Armenia<\/option><option value=\"AW\">Aruba<\/option><option value=\"AS\">American Samoa<\/option><option value=\"AT\">Austria<\/option><option value=\"AZ\">Azerbaijan<\/option><option value=\"BS\">Bahamas<\/option><option value=\"BH\">Bahrain<\/option><option value=\"BD\">Bangladesh<\/option><option value=\"BB\">Barbados<\/option><option value=\"BY\">Belarus<\/option><option value=\"BE\">Belgium<\/option><option value=\"PW\">Belau<\/option><option value=\"BZ\">Belize<\/option><option value=\"BJ\">Benin<\/option><option value=\"BM\">Bermuda<\/option><option value=\"BT\">Bhutan<\/option><option value=\"BO\">Bolivia<\/option><option value=\"BQ\">Bonaire, Saint Eustatius and Saba<\/option><option value=\"BA\">Bosnia and Herzegovina<\/option><option value=\"BW\">Botswana<\/option><option value=\"BV\">Bouvet Island<\/option><option value=\"BR\">Brazil<\/option><option value=\"IO\">British Indian Ocean Territory<\/option><option value=\"VG\">British Virgin Islands<\/option><option value=\"BN\">Brunei<\/option><option value=\"BG\">Bulgaria<\/option><option value=\"BF\">Burkina Faso<\/option><option value=\"BI\">Burundi<\/option><option value=\"KH\">Cambodia<\/option><option value=\"CM\">Cameroon<\/option><option value=\"CV\">Cape Verde<\/option><option value=\"KY\">Cayman Islands<\/option><option value=\"CF\">Central African Republic<\/option><option value=\"TD\">Chad<\/option><option value=\"CL\">Chile<\/option><option value=\"CN\">China<\/option><option value=\"CX\">Christmas Island<\/option><option value=\"CC\">Cocos (Keeling) Islands<\/option><option value=\"CO\">Colombia<\/option><option value=\"KM\">Comoros<\/option><option value=\"CG\">Congo (Brazzaville)<\/option><option value=\"CD\">Congo (Kinshasa)<\/option><option value=\"CK\">Cook Islands<\/option><option value=\"CR\">Costa Rica<\/option><option value=\"HR\">Croatia<\/option><option value=\"CU\">Cuba<\/option><option value=\"CW\">Cura&Ccedil;ao<\/option><option value=\"CY\">Cyprus<\/option><option value=\"CZ\">Czech Republic<\/option><option value=\"DK\">Denmark<\/option><option value=\"DJ\">Djibouti<\/option><option value=\"DM\">Dominica<\/option><option value=\"DO\">Dominican Republic<\/option><option value=\"EC\">Ecuador<\/option><option value=\"EG\">Egypt<\/option><option value=\"SV\">El Salvador<\/option><option value=\"GQ\">Equatorial Guinea<\/option><option value=\"ER\">Eritrea<\/option><option value=\"EE\">Estonia<\/option><option value=\"ET\">Ethiopia<\/option><option value=\"FK\">Falkland Islands<\/option><option value=\"FO\">Faroe Islands<\/option><option value=\"FJ\">Fiji<\/option><option value=\"FI\">Finland<\/option><option value=\"FR\">France<\/option><option value=\"GF\">French Guiana<\/option><option value=\"PF\">French Polynesia<\/option><option value=\"TF\">French Southern Territories<\/option><option value=\"GA\">Gabon<\/option><option value=\"GM\">Gambia<\/option><option value=\"GE\">Georgia<\/option><option value=\"DE\">Germany<\/option><option value=\"GH\">Ghana<\/option><option value=\"GI\">Gibraltar<\/option><option value=\"GR\">Greece<\/option><option value=\"GL\">Greenland<\/option><option value=\"GD\">Grenada<\/option><option value=\"GP\">Guadeloupe<\/option><option value=\"GT\">Guatemala<\/option><option value=\"GG\">Guernsey<\/option><option value=\"GN\">Guinea<\/option><option value=\"GW\">Guinea-Bissau<\/option><option value=\"GY\">Guyana<\/option><option value=\"HT\">Haiti<\/option><option value=\"HM\">Heard Island and McDonald Islands<\/option><option value=\"HN\">Honduras<\/option><option value=\"HK\">Hong Kong<\/option><option value=\"HU\">Hungary<\/option><option value=\"IS\">Iceland<\/option><option value=\"IN\">India<\/option><option value=\"ID\">Indonesia<\/option><option value=\"IR\">Iran<\/option><option value=\"IQ\">Iraq<\/option><option value=\"IE\">Republic of Ireland<\/option><option value=\"IM\">Isle of Man<\/option><option value=\"IL\">Israel<\/option><option value=\"IT\">Italy<\/option><option value=\"CI\">Ivory Coast<\/option><option value=\"JM\">Jamaica<\/option><option value=\"JP\">Japan<\/option><option value=\"JE\">Jersey<\/option><option value=\"JO\">Jordan<\/option><option value=\"KZ\">Kazakhstan<\/option><option value=\"KE\">Kenya<\/option><option value=\"KI\">Kiribati<\/option><option value=\"KW\">Kuwait<\/option><option value=\"KG\">Kyrgyzstan<\/option><option value=\"LA\">Laos<\/option><option value=\"LV\">Latvia<\/option><option value=\"LB\">Lebanon<\/option><option value=\"LS\">Lesotho<\/option><option value=\"LR\">Liberia<\/option><option value=\"LY\">Libya<\/option><option value=\"LI\">Liechtenstein<\/option><option value=\"LT\">Lithuania<\/option><option value=\"LU\">Luxembourg<\/option><option value=\"MO\">Macao S.A.R., China<\/option><option value=\"MK\">Macedonia<\/option><option value=\"MG\">Madagascar<\/option><option value=\"MW\">Malawi<\/option><option value=\"MY\">Malaysia<\/option><option value=\"MV\">Maldives<\/option><option value=\"ML\">Mali<\/option><option value=\"MT\">Malta<\/option><option value=\"MH\">Marshall Islands<\/option><option value=\"MQ\">Martinique<\/option><option value=\"MR\">Mauritania<\/option><option value=\"MU\">Mauritius<\/option><option value=\"YT\">Mayotte<\/option><option value=\"MX\">Mexico<\/option><option value=\"FM\">Micronesia<\/option><option value=\"MD\">Moldova<\/option><option value=\"MC\">Monaco<\/option><option value=\"MN\">Mongolia<\/option><option value=\"ME\">Montenegro<\/option><option value=\"MS\">Montserrat<\/option><option value=\"MA\">Morocco<\/option><option value=\"MZ\">Mozambique<\/option><option value=\"MM\">Myanmar<\/option><option value=\"NA\">Namibia<\/option><option value=\"NR\">Nauru<\/option><option value=\"NP\">Nepal<\/option><option value=\"NL\">Netherlands<\/option><option value=\"AN\">Netherlands Antilles<\/option><option value=\"NC\">New Caledonia<\/option><option value=\"NZ\">New Zealand<\/option><option value=\"NI\">Nicaragua<\/option><option value=\"NE\">Niger<\/option><option value=\"NG\">Nigeria<\/option><option value=\"NU\">Niue<\/option><option value=\"NF\">Norfolk Island<\/option><option value=\"KP\">North Korea<\/option><option value=\"NO\">Norway<\/option><option value=\"OM\">Oman<\/option><option value=\"PK\">Pakistan<\/option><option value=\"PS\">Palestinian Territory<\/option><option value=\"PA\">Panama<\/option><option value=\"PG\">Papua New Guinea<\/option><option value=\"PY\">Paraguay<\/option><option value=\"PE\">Peru<\/option><option value=\"PH\">Philippines<\/option><option value=\"PN\">Pitcairn<\/option><option value=\"PL\">Poland<\/option><option value=\"PT\">Portugal<\/option><option value=\"QA\">Qatar<\/option><option value=\"RE\">Reunion<\/option><option value=\"RO\">Romania<\/option><option value=\"RU\">Russia<\/option><option value=\"RW\">Rwanda<\/option><option value=\"BL\">Saint Barth&eacute;lemy<\/option><option value=\"SH\">Saint Helena<\/option><option value=\"KN\">Saint Kitts and Nevis<\/option><option value=\"LC\">Saint Lucia<\/option><option value=\"MF\">Saint Martin (French part)<\/option><option value=\"SX\">Saint Martin (Dutch part)<\/option><option value=\"PM\">Saint Pierre and Miquelon<\/option><option value=\"VC\">Saint Vincent and the Grenadines<\/option><option value=\"SM\">San Marino<\/option><option value=\"ST\">S&atilde;o Tom&eacute; and Pr&iacute;ncipe<\/option><option value=\"SA\">Saudi Arabia<\/option><option value=\"SN\">Senegal<\/option><option value=\"RS\">Serbia<\/option><option value=\"SC\">Seychelles<\/option><option value=\"SL\">Sierra Leone<\/option><option value=\"SG\">Singapore<\/option><option value=\"SK\">Slovakia<\/option><option value=\"SI\">Slovenia<\/option><option value=\"SB\">Solomon Islands<\/option><option value=\"SO\">Somalia<\/option><option value=\"ZA\">South Africa<\/option><option value=\"GS\">South Georgia\/Sandwich Islands<\/option><option value=\"KR\">South Korea<\/option><option value=\"SS\">South Sudan<\/option><option value=\"ES\">Spain<\/option><option value=\"LK\">Sri Lanka<\/option><option value=\"SD\">Sudan<\/option><option value=\"SR\">Suriname<\/option><option value=\"SJ\">Svalbard and Jan Mayen<\/option><option value=\"SZ\">Swaziland<\/option><option value=\"SE\">Sweden<\/option><option value=\"CH\">Switzerland<\/option><option value=\"SY\">Syria<\/option><option value=\"TW\">Taiwan<\/option><option value=\"TJ\">Tajikistan<\/option><option value=\"TZ\">Tanzania<\/option><option value=\"TH\">Thailand<\/option><option value=\"TL\">Timor-Leste<\/option><option value=\"TG\">Togo<\/option><option value=\"TK\">Tokelau<\/option><option value=\"TO\">Tonga<\/option><option value=\"TT\">Trinidad and Tobago<\/option><option value=\"TN\">Tunisia<\/option><option value=\"TR\">Turkey<\/option><option value=\"TM\">Turkmenistan<\/option><option value=\"TC\">Turks and Caicos Islands<\/option><option value=\"TV\">Tuvalu<\/option><option value=\"UG\">Uganda<\/option><option value=\"UA\">Ukraine<\/option><option value=\"AE\">United Arab Emirates<\/option><option value=\"UY\">Uruguay<\/option><option value=\"UZ\">Uzbekistan<\/option><option value=\"VU\">Vanuatu<\/option><option value=\"VA\">Vatican<\/option><option value=\"VE\">Venezuela<\/option><option value=\"VN\">Vietnam<\/option><option value=\"WF\">Wallis and Futuna<\/option><option value=\"EH\">Western Sahara<\/option><option value=\"WS\">Western Samoa<\/option><option value=\"YE\">Yemen<\/option><option value=\"ZM\">Zambia<\/option><option value=\"ZW\">Zimbabwe<\/option><\/select><\/div><div class=\"vfb-form-group\" style=\"\"><label for=\"vfb-field-694-city\" class=\"vfb-address-label\">City<\/label><input id=\"vfb-field-694-city\" class=\"vfb-form-control vfb-addresspart-city\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-694[city]\"><\/div><div class=\"vfb-form-group\" style=\"\"><label for=\"vfb-field-694-province\" class=\"vfb-address-label\">State<\/label><select id=\"vfb-field-694-province\" class=\"vfb-form-control vfb-addresspart-province\" placeholder=\"\" required=\"required\" name=\"vfb-field-694[province]\"><option value=\"\"><\/option><option value=\"AL\">Alabama<\/option><option value=\"AK\">Alaska<\/option><option value=\"AZ\">Arizona<\/option><option value=\"AR\">Arkansas<\/option><option value=\"CA\">California<\/option><option value=\"CO\">Colorado<\/option><option value=\"CT\">Connecticut<\/option><option value=\"DE\">Delaware<\/option><option value=\"DC\">District Of Columbia<\/option><option value=\"FL\">Florida<\/option><option value=\"GA\">Georgia<\/option><option value=\"HI\">Hawaii<\/option><option value=\"ID\">Idaho<\/option><option value=\"IL\">Illinois<\/option><option value=\"IN\">Indiana<\/option><option value=\"IA\">Iowa<\/option><option value=\"KS\">Kansas<\/option><option value=\"KY\">Kentucky<\/option><option value=\"LA\">Louisiana<\/option><option value=\"ME\">Maine<\/option><option value=\"MD\">Maryland<\/option><option value=\"MA\">Massachusetts<\/option><option value=\"MI\">Michigan<\/option><option value=\"MN\">Minnesota<\/option><option value=\"MS\">Mississippi<\/option><option value=\"MO\">Missouri<\/option><option value=\"MT\">Montana<\/option><option value=\"NE\">Nebraska<\/option><option value=\"NV\">Nevada<\/option><option value=\"NH\">New Hampshire<\/option><option value=\"NJ\">New Jersey<\/option><option value=\"NM\">New Mexico<\/option><option value=\"NY\">New York<\/option><option value=\"NC\">North Carolina<\/option><option value=\"ND\">North Dakota<\/option><option value=\"OH\">Ohio<\/option><option value=\"OK\">Oklahoma<\/option><option value=\"OR\">Oregon<\/option><option value=\"PA\">Pennsylvania<\/option><option value=\"RI\">Rhode Island<\/option><option value=\"SC\">South Carolina<\/option><option value=\"SD\">South Dakota<\/option><option value=\"TN\">Tennessee<\/option><option value=\"TX\">Texas<\/option><option value=\"UT\">Utah<\/option><option value=\"VT\">Vermont<\/option><option value=\"VA\">Virginia<\/option><option value=\"WA\">Washington<\/option><option value=\"WV\">West Virginia<\/option><option value=\"WI\">Wisconsin<\/option><option value=\"WY\">Wyoming<\/option><option value=\"AA\">Armed Forces (AA)<\/option><option value=\"AE\">Armed Forces (AE)<\/option><option value=\"AP\">Armed Forces (AP)<\/option><option value=\"AS\">American Samoa<\/option><option value=\"GU\">Guam<\/option><option value=\"MP\">Northern Mariana Islands<\/option><option value=\"PR\">Puerto Rico<\/option><option value=\"UM\">US Minor Outlying Islands<\/option><option value=\"VI\">US Virgin Islands<\/option><\/select><\/div><div class=\"vfb-form-group\" style=\"\"><label for=\"vfb-field-694-zip\" class=\"vfb-address-label\">Zip code<\/label><input id=\"vfb-field-694-zip\" class=\"vfb-form-control vfb-addresspart-zip\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-694[zip]\"><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-name\" id=\"vfbField695\"><div class=\"vfb-form-group\"><label for=\"vfb-field-695\" class=\"vfb-control-label\">Emergency Contact if Different than Parents<\/label><div class=\"vfb-name-block\"><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-695-first\" class=\"vfb-form-control vfb-namepart-first\" placeholder=\"First\" type=\"text\" name=\"vfb-field-695[first]\"><\/div><\/div><div class=\"vfb-form-group\"><div class=\"vfb-col-6\"><input id=\"vfb-field-695-last\" class=\"vfb-form-control vfb-namepart-last\" placeholder=\"Last\" type=\"text\" name=\"vfb-field-695[last]\"><\/div><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-form-group vfb-col-12\"><div><div class=\"\"><\/div><span class=\"vfb-help-block\"><p style=\"text-align: center;\"><strong><em><span style=\"color: #3366ff;\">Health Insurance Verification<\/span><\/em><\/strong><\/p>\r\n<p style=\"text-align: center;\">I the parent or legal guardian of the above named participant verifies that said participant has complete and legitimate health insurance through the carrier listed below, and I understand that Washington Junior Football League does not provide individual health insurance for the above named child.<\/p><\/span><\/div><\/div><div class=\"vfb-col-12 vfb-fieldType-heading\" id=\"vfbField696\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField697\"><div class=\"vfb-form-group\"><label for=\"vfb-field-697\" class=\"vfb-control-label\">Please Provide the Name of Health and Accident Insurance Coverage\/Company <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-697\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-697\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-form-group vfb-col-12\"><div><div class=\"\"><\/div><span class=\"vfb-help-block\"><span style=\"color: #3366ff;\"><em><strong>Health History<\/strong><\/em><\/span><\/span><\/div><\/div><div class=\"vfb-col-12 vfb-fieldType-heading\" id=\"vfbField698\"><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-checkbox\" id=\"vfbField699\"><label for=\"vfb-field-699\" class=\"vfb-control-label\">Have or Subject to:  (Please Select All that Apply) <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-699-0\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-699\" required=\"required\" type=\"checkbox\" name=\"vfb-field-699[0]\" value=\"1\">Asthma<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-699-1\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-699\" type=\"checkbox\" name=\"vfb-field-699[1]\" value=\"1\">Fainting Spells<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-699-2\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-699\" type=\"checkbox\" name=\"vfb-field-699[2]\" value=\"1\">Convulsions<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-699-3\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-699\" type=\"checkbox\" name=\"vfb-field-699[3]\" value=\"1\">Diabetes<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-699-4\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-699\" type=\"checkbox\" name=\"vfb-field-699[4]\" value=\"1\">Heart Trouble<\/label><\/div><div class=\"vfb-checkbox\"><label><input id=\"vfb-field-699-5\" class=\"\" placeholder=\"\" data-vfb-multiple=\"vfb-field-699\" type=\"checkbox\" name=\"vfb-field-699[5]\" value=\"1\">None<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField700\"><div class=\"vfb-form-group\"><label for=\"vfb-field-700\" class=\"vfb-control-label\">Other - Please Explain<\/label><div><input id=\"vfb-field-700\" class=\"vfb-form-control\" placeholder=\"\" type=\"text\" name=\"vfb-field-700\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField701\"><div class=\"vfb-form-group\"><label for=\"vfb-field-701\" class=\"vfb-control-label\">Please Describe Allergies or Reaction to any Medication <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-701\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-701\" value=\"\"><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField702\"><div class=\"vfb-form-group\"><label for=\"vfb-field-702\" class=\"vfb-control-label\">Any Condition Now Requiring Regular Medication?  If so, please name condition and medication. <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-702\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-702\" value=\"\"><span class=\"vfb-help-block\">If so, please name condition and medication.<\/span><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-text\" id=\"vfbField703\"><div class=\"vfb-form-group\"><label for=\"vfb-field-703\" class=\"vfb-control-label\">Any restriction of activity for medical reasons?   <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><input id=\"vfb-field-703\" class=\"vfb-form-control\" placeholder=\"\" required=\"required\" type=\"text\" name=\"vfb-field-703\" value=\"\"><span class=\"vfb-help-block\">If so, please explain.<\/span><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField704\"><label for=\"vfb-field-704\" class=\"vfb-control-label\">Parent Emergency Medical Authorization <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-help-block\">This health history is correct so far as I know, and the person herein described has permission to engage in all prescribed activities, except as noted by me and the physician. In the event I cannot be reached in an emergency, I hereby give permission to the physician, selected by the adult leader in charge, to hospitalize, secure proper anesthesia, or to order injection or surgery for my son\/daughter.<\/span><div class=\"vfb-radio\"><label><input id=\"vfb-field-704-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-704\" value=\"Yes, I grant permission.\">Yes, I grant permission.<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-704-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-704\" value=\"No, I do not grant permission.\">No, I do not grant permission.<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField705\"><label for=\"vfb-field-705\" class=\"vfb-control-label\">Parental Permission\/Agreement To Participate <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-help-block\">I the parent or legal guardian of aforementioned child, do hereby, consent and agree that the above named minor may participate in Washington Junior Football League. It is agreed that the named association or sponsor assumes no legal liability for injuries or other loss as a result of such participation. It is further agreed that this consent shall remain in full force and effect until such time as the undersigned parent or legal guardian shall notify Washington Junior Football League in writing of the abrogation or cancellation of this consent. I do, also hereby agree that all equipment loaned to the above named player shall be returned immediately to Washington Junior Football League upon the completion of the current season or the withdrawal of the above named player from participation in Washington Junior Football League. I do, also hereby agree to accept all provisions outlined in the Four Rivers YFL Constitution and By-Laws, WJFL Constitution and By-Laws and Parent Letter.<\/span><div class=\"vfb-radio\"><label><input id=\"vfb-field-705-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-705\" value=\"Yes, I grant permission.\">Yes, I grant permission.<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-705-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-705\" value=\"No, I do not grant permission.\">No, I do not grant permission.<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField706\"><label for=\"vfb-field-706\" class=\"vfb-control-label\">SFBRHS and Washington School District Release <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-help-block\">(This release must be signed for your child to practice or play games on SFBRHS or Washington School District Property)\r\nThe undersigned, a parent and\/or guardian of a participant in Washington Junior Football League Inc., hereby releases, remises, and forever discharges St. Francis Borgia Regional High School and the Washington School District, its agents, successors and assigns, and all other persons, firms or corporations liable, or who might be claimed to be liable, none of whom admit any liability to the undersigned, but all expressly deny any liability from any and all claims, demands, damages, actions, causes of action, or suits of any kind or nature whatsoever, and particularly on account of all damages, known and unknown, both to person or property, which may result in the future from the use of St. Francis Borgia Regional High School and\/or Washington School District property.\r\nThe undersigned hereby declares that the terms of this settlement have been completely read and are fully understood and voluntarily accepted for the purpose of making a full and final compromise adjustment and settlement of any and all future claims, disputed or otherwise, on account of the damages above mentioned.\r\nThe undersigned further declares and represents that no promise, inducement or agreement not herein expressed has been made to the undersigned, and that the terms hereof are contractual and not a mere recital.\r\n\r\nTHE UNDERSIGNED HAVE READ THE FORERGOING RELEASE AND FULLY UNDERSTAND IT.<\/span><div class=\"vfb-radio\"><label><input id=\"vfb-field-706-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-706\" value=\"Yes, I grant permission.\">Yes, I grant permission.<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-706-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-706\" value=\"No, I do not grant permission.\">No, I do not grant permission.<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField707\"><label for=\"vfb-field-707\" class=\"vfb-control-label\">Media\/Marketing Permission <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-help-block\">Washington Junior Football League Inc. may throughout the year use your child\u2019s photo in press releases, postings on our website, Facebook, Twitter, promotional brochures, etc. Your child\u2019s name will be listed on a game program and roster posted on the association website. I understand my child\u2019s image may be used on WJFL media Materials.<\/span><div class=\"vfb-radio\"><label><input id=\"vfb-field-707-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-707\" value=\"Yes, I grant permission.\">Yes, I grant permission.<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-707-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-707\" value=\"No, I do not grant permission.\">No, I do not grant permission.<\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-radio\" id=\"vfbField708\"><label for=\"vfb-field-708\" class=\"vfb-control-label\">Coaching Help <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><span class=\"vfb-help-block\">If you are available or willing to help coach please check the appropriate line below. Coaches are expected to attend any training sessions, comply with all background checks, adhere to all WJFL and Four Rivers YFL guidelines and by-laws and help out at all WJFL events.<\/span><div class=\"vfb-radio\"><label><input id=\"vfb-field-708-0\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-708\" value=\"I would like to be a head coach at my child&#039;s grade level.  \">I would like to be a head coach at my child's grade level.  <\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-708-1\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-708\" value=\"I would be willing to help coach my childs&#039; team.  \">I would be willing to help coach my childs' team.  <\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-708-2\" class=\"\" placeholder=\"\" required=\"required\" type=\"radio\" name=\"vfb-field-708\" value=\"Not Interested\">Not Interested<\/label><\/div><div class=\"vfb-radio\"><label><input id=\"vfb-field-708-3\" class=\"\" placeholder=\"\" type=\"radio\" name=\"vfb-field-708\" value=\"I would like to coach with:\">I would like to coach with:<input class=\"vfb-form-control\" id=\"vfb-field-708-other\" type=\"text\" name=\"vfb-field-708-other\" value=\"\"><\/label><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-captcha\" id=\"vfbField709\"><div class=\"vfb-form-group\"><label for=\"vfb-field-709\" class=\"vfb-control-label\">Captcha <span class=\"vfb-required-asterisk\">*<\/span><\/label><div><div class=\"g-recaptcha\" data-sitekey=\"6LcRPgMTAAAAAI9G9h8D5p4kd8glUu75cpQKqLBz\"><\/div><input type=\"hidden\" name=\"_vfb_recaptcha_enabled\" value=\"1\" id=\"\"><div class=\"vfb-has-error\" id=\"vfb-recaptcha-error\"><span class=\"vfb-help-block\">reCAPTCHA is required.<\/span><\/div><\/div><\/div><\/div><div class=\"vfb-clearfix\"><\/div><div class=\"vfb-col-12 vfb-fieldType-submit\" id=\"vfbField710\"><button id=\"vfb-field-710\" class=\" btn btn-primary\" placeholder=\"\" type=\"submit\" name=\"_vfb-submit\">Submit<\/button><\/div><div class=\"vfb-clearfix\"><\/div><\/form>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":10744,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"http:\/\/www.wjfl.org\/index.php\/wp-json\/wp\/v2\/pages\/18069"}],"collection":[{"href":"http:\/\/www.wjfl.org\/index.php\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"http:\/\/www.wjfl.org\/index.php\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"http:\/\/www.wjfl.org\/index.php\/wp-json\/wp\/v2\/users\/10744"}],"replies":[{"embeddable":true,"href":"http:\/\/www.wjfl.org\/index.php\/wp-json\/wp\/v2\/comments?post=18069"}],"version-history":[{"count":3,"href":"http:\/\/www.wjfl.org\/index.php\/wp-json\/wp\/v2\/pages\/18069\/revisions"}],"predecessor-version":[{"id":19168,"href":"http:\/\/www.wjfl.org\/index.php\/wp-json\/wp\/v2\/pages\/18069\/revisions\/19168"}],"wp:attachment":[{"href":"http:\/\/www.wjfl.org\/index.php\/wp-json\/wp\/v2\/media?parent=18069"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}