All Forms - Alamo City Red Raiders

Transcription

All Forms - Alamo City Red Raiders
ALAMO CITY RED RAIDERS
TEAM REGISTRATION FORM
TOURNAMENT NAME:___________________________________
TOURNAMENT DATE:_______________________
Team Name: _______________________________State / Region:________________________
Head Coach:____________________________ Email Address:_____________________________
Address: ____________________________________ City/Zip Code: ___________________________
Home Phone #: _______________________ Cell Phone #: __________________________________
List Assistant Coaches Below:
1._______________________________________ 4.________________________________________
2.________________________________________5.________________________________________
3.________________________________________6.________________________________________
Age Brackets (check all teams that apply – Age as of August 1st)
8U____10U_____12U_____14U_____16U____
ENTRY FEE: $300 PER TEAM
x ______TEAMS ENTERED = $____________
Entry fee made payable to: Alamo City Red Raiders
*Cashier’s Check or Money Order ONLY*
Mail Completed Registration Form, Team Roster (on our form), & Payment to:
Alamo City Red Raiders
C/O Frank Lamanna
210-254-4632
Call for mailing address
For Add’l Information:
Please Call
Jeff Tristan (210) 291-8343 or Marlowe Benavidez (210) 218-7679
ALAMO CITY RED RAIDERS
Publications, Video, Internet Consent & Release Agreement
Players who attend any Alamo City Red Raider (ACRR) events are occasionally asked to be a part of publicity, publications and/or public relations activities. In order to guarantee players privacy and ensure your agreement for your son or daughter to participate, the Alamo City Red Raiders asks that you and the player sign and return this form. The form referenced below indicates approval for your child’s name, picture, voice, verbal statements or portraits (video or still) to appear in ACRR publicity, publications, videos or on the ACRR website. For example, pictures and articles about ACRR activities may appear in local newspapers, websites or other publications. These pictures and articles may or may not personally identify the player. The ACRR may use the pictures and/or videos in subsequent years. AGREEMENT Student and Parent/Guardian release to Alamo City Red Raiders (ACRR) the student’s name, picture, voice, verbal statements, portraits (video or still) and consent to their use by Alamo City Red Raiders. ACRR agrees that the student’s name, picture, voice, verbal statements, portraits (video or still) shall only be used for public relations, public information, ACRR promotion, publicity, instruction and website. Student and Parent/Guardian understand and agree that: ‐
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No monetary consideration shall be paid; Consent and release have been given without coercion or duress; This agreement is binding upon heirs and/or future legal representatives; The photo, video or student statements may be used in subsequent years. If the Student and Parent/Guardian wish to rescind this agreement, they may do so at any time with written notice. Effective Date of Agreement:___________________________________________ Student Name (please print):______________________________________________ Student Signature:____________________________________________________ Parent/Guardian (please print):_____________________________________________ Parent/Guardian Signature):_____________________________________________ ACRR publications internet consent form .doc ALAMO CITY RED RAIDERS
Medical Consent Form
NAME OF PARTICIPANT:________________________________________________AGE:_________________
ADDRESS:__________________________________________CITY/STATE/ZIP__________________________
TELEPHONE NUMBERS: HOME (___)_____________________WORK ( ___)___________________________
Does your child have any severe medical problems, i.e. asthma, allergic to medications, allergic to bee stings, heart
trouble, epilepsy, diabetes, physical handicaps, etc? Please specify:
_____________________________________________________________________________________________
Should there be any limits on his/hers physical activity? If so, what are they?
_____________________________________________________________________________________________
Has your child had any serious illness in the last three years? If yes, please explain:
_____________________________________________________________________________________________
May we contact the doctor for medical reports? YES_________NO_________
In case of emergency, person to contact if parent/guardian cannot be reached?
Name________________________________________Address_________________________________________
City/State/Zip__________________________Telephone Number_______________________________________
What relationship is this person to the program participant?
____________________________________________________________
Is the participant covered by medical insurance? YES____NO____
Please provide medical coverage information (Provider).
Insurance Company: ___________________________________________
Policy Holder:________________________________________________ Insurance Card #___________________
When was the last time your son/daughter had a complete physical examination?
Date________________________________ Dr’s Name_______________________________________________
Address______________________________City/State/Zip______________________Telephone #_____________
I do hereby authorize the performance of medical examinations and necessary treatments (including tests, x‐rays, drugs, etc) as may be deemed advisable for the period of time that my minor child or legal ward is enrolled as a participant in the Alamo City Red Raiders Organization. If an emergency arises requiring a major medical procedure, the program will attempt to reach me and to be guided by my wishes, but if I cannot be reached, I authorize the attending physician to act as medical judgment may dictate. __________________________________________________________________________________ _____________________________________________________________________ Parent /Guardian Signature Date ALAMO CITY RED RAIDERS
PARENT/GUARDIAN RELEASE OF LIABILITY & INDEMNITY FOR MINOR
CHILD’S PARTICIPATION IN PROGRAM
IMPORTANT DOCUMENT‐READ BEFORE SIGNING In consideration of (PRINT NAME)________________________________, my minor child or legal ward (my “child”), being allowed to participate in the Alamo City Red Raiders Organization, related events and activities, the undersigned parent hereby acknowledges and agrees as follows: 1. The activities of this program may have significant risk of injury, including potential permanent paralysis and death. Rules, equipment, and personal discipline are designed to reduce the risk. However, there is always a risk of serious injury. 2. I will instruct my Child to comply with the rules governing participation in this program. If I have concern about my Child’s ability to participate in the program, or about the program itself, I will remove my Child from participating and immediately inform the nearest program official of my concern. 3. I, for myself and for my Child, and for all heirs, assign, personal representatives, and next of kin of myself and/or my Child, HEREBY RELEASE Alamo City Red Raiders, The Alamo City Winter Bowl, their officers, officials, agents, volunteers, and employees, other program participants, sponsors and sponsoring agencies of the program, and owners and lessors of any used to conduct the program (“RELEASEES”) FROM ANY LIABILITY FOR ANY INJURY, DISABILITY OR DEATH OF THE MINOR, LOSS OR DAMAGE TO PROPERTY ARISING OUT OF PARTICIPATING OF THE MINOR IN THE PROGRAM, WHETHER ARISING FROM THE SOLE NEGLIGENCE OF RELEASEES OR OTHERWISE, TO THE FULLEST EXTENT PERMITTED BY LAW. 4. I HEREBY ASSUME ALL RISK OF INJURY, known and unknown, to my Child arising from participation in the program, AND ASSUME FULL RESPONSIBILITY FOR PARTICIPATION OF MY CHILD. 5. I, for myself and my Child, and for all of heirs, assign, personal representatives and next of kin of the Minor, HEREBY INDEMNIFY AND HOLD HARMLESS THE RELEASEES, AND EACH OF THEM, FOR ANY AND ALL LIABILITIES INCIDENT TO THE PARTICIPATION OF THE MINOR IN THE PROGRAM, EVEN IF ARISING FROM THE SOLE NEGLIGENCE OF THE RELEASEES, TO THE FULLEST EXTENT PERMITTED BY LAW. I HAVE READ THIS DOCUMENT IN ITS ENTIRETY, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE WAIVED SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY, VOLUNTARILY, AND WITHOUT ANY INDUCEMENT. Signature of Parent/Guardian:______________________________________Dated:_________________________ Name (Please Print)______________________________________________ I HAVE READ THE PARAGRAPH ABOVE AND UNDERSTAND AND AGREE WITH WHAT I HAVE READ, AND CHOOSE TO SIGN THIS STATEMENT. I WILL ACCEPT ALL RISK OF BEING HURT, KNOWN AND UNKNOWN, AND TAKE FULL RESPONSIBILITY FOR MY BEHAVIOR. Signature of Minor Participant:______________________________________Dated:_________________________ Name (Please Print)______________________________________________ Alamo City Red Raiders Tournament
Player/Parent Code of Conduct
For Players:
I pledge the following...
1.
I will demonstrate Good Sportsman like conduct regardless of the score and/or calls made.
2.
I will be respectful of all game officials, coaches, players, parents and facilities at all times.
3.
I will not argue with or question the decisions made by the on-field game officials.
4.
I will NOT fight on the field or leave the bench in the occurrence of a fight on the field.
5.
I will not use drugs, tobacco or alcohol at any practice, game or facility that is hosting/housing me as I participate
in the tournament.
6.
I will shake hands with the other team at the conclusion of all games.
7.
I will shake hands with the officials at the conclusion of all games.
I understand that I can be suspended from the game and/or tournament play for violation of this Player's Code of Conduct.
_____________________________________
Player Signature
_________________________________
Date
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For Parents:
The essential elements of character building and ethics in sports are embodied in the concept of sportsmanship and the six core
principles: respect, trustworthiness, responsibility, caring, fairness and good citizenship. I _____________________, parent of
______________________ agree:
1.
I will remember that children participate to have FUN and that the game is for YOUTH, not adults.
2.
I will learn the rules of the game and the policies of the league.
3.
I and my guests, will demonstrate POSITIVE SUPPORT for all players, coaches, officials and spectators at every game.
4.
I and my guests, will be a POSITIVE ROLE MODEL for my child & encourage sportsmanship by showing respect and
courtesy.
5.
I and my guests, will NOT engage in any kind of unsportsmanlike conduct with any official, coach, player or parent.
6.
I and my guests, will not engage in tactics such as booing or taunting.
7.
I will teach my child to play by the rules to resolve conflicts without resorting to hostility or violence.
8.
I will demand that my child treat other players, coaches, officials and spectators with RESPECT.
9.
I will praise my child for competing fairly and trying hard.
10.
I WILL Make My Child Feel Like A WINNER EVERY TIME.
11.
I will promote the emotional and physical well-being of the athletes ahead of my personal desire I may have for my child to
win.
12.
I will respect the officials, game administrators and their authority before, during and after the game.
13.
I will never question, discuss or confront coaches at the game – either during and after games.
14.
I WILL DEMAND a sports environment for my child that is FREE from DRUGS, Tobacco and Alcohol and I will refrain
from their use at all sports events.
15.
I will refrain from coaching my child or other players during games and practices, unless I am one of the official coaches of
the team.
I also agree that if I FAIL to abide by the aforementioned rules and guidelines at practices, games & Red Raider Tournament
Hotel Sites, I will be subject to disciplinary action that could include, but is not limited to the following:
Verbal warning by game officials, head coach and/or head of league organization
Parental game or season or tournament suspension
Game Unsportsmanlike Conduct Penalty Assessed Against Team
Team Game Forfeit Through The Official or Coach.
NO REFUND WILL BE GIVEN if the Team Game is forfeited or The Team is EJECTED as a result of any
disorderly conduct.
________________________________________
_____________________________
Parent Signature
Date