Girls Personnel Form for GHS Spring Frisbee

Transcription

1 Girls Personnel Form for GHS Spring Frisbee Player Information Player s Name: Player s Address: Parent s Address: ***NOTE addresses will automatically be added to player and parent lists. If you do not wish to be on our lists, please make a note*** Does the player have a DiscNW account already? Y N DiscNW Account login name or address: Players without a DiscNW login must sign up for one at You can then login info to ghsultimate@gmail.com. Grade Level for school year: (please circle one) Neighborhood: Player s Phone #: Allergies/Medical Info: Parental Information Primary Contact Name: Relationship to Player: Cell Number: Work Number: Secondary Contact: Relationship to Player: Cell Number: Work Number:

2 Jersey Check List I would like to purchase the following jersey items: Shorts Size (circle one) XL L Med Sm XS Jersey Size (circle one) XL L Med Sm XS Jersey Name (print legibly): Jersey Number (The following #s are NOT available) 1, 2, 4, 8, 9, 18, 22, 24, 25, and 50 Given the above info list 5 jersey # choices in order (choices must be single or double digit only): Payment Check List 1 st 2 nd 3 rd 4 th 5 th My payment is to include the following fees (mark all that apply with X, those in italics are optional for non-tournament players): Girls Dues Tournament Player (Fields, Supplies, Coach CPR Training, Tournament Fees, and Coaching Stipends) $ Girls Dues Practice Player (Fields, Supplies, Coach CPR Training, and Coaching Stipends) $130 Purple Jersey (w/ individual name and number) $35 White Jersey (w/ individual name and number) $35 Shorts (w/ individual number) $28 TOTAL of above items In addition to the above items I would like to donate to the GHS Frisbee Program for scholarship help for other players and to support a team rainy day fund. (check one and fill out amount as appropriate) Yes No Amount to donate Please total the above costs (dues + jerseys + donation) and write it here: The amount listed on the line above should be submitted along with this 2 page form to Coach Scofield-Selby, Coach Gu, or Coach Titcomb by May 1st, Checks should be made to GARFIELD ULTIMATE FRISBEE, and the full player name should be listed on the memo line. If paying in cash please put it in an envelope with the player name on the envelope.

3 Ultimate Frisbee Waiver - Permission Form Player Name Age Name of School Garfield High School Name of Coach(es): Rusty Brown, Sophie Scofield-Selby, Lili Gu, Peter Kapostasy, Homer Aalfs, Jason Peacher-Ton, Alex Strong, Kavik Frol, Qxhna Titcomb, and Noah Boudra Players Primary Address: Zip Parent and student athlete must both read and sign This Participation and Agreement Release must be signed before a player may participate in any practice, game, or activity on the HS team coached by the coach(es) listed above. If the coaches listed are not at the activity then it is not a team activity and the team will not be allowed to play. (Player s name) would like to participate in youth ultimate Frisbee events for the high school team NOT officially recognized or insured by the high school listed above. I (we) recognize that ultimate is a hazardous and dangerous activity with inherent risks. I (we) recognize that such risks can lead to serious injury or death. I (we) have voluntarily made a choice to participate in these activities and expressly assume and accept the risks inherent in said activities. I (we) accept our (my) responsibility to be informed, to behave prudently, to conduct myself (ourselves) in a safe manner, and to read and abide by all reasonable and available sources of information about the activities. I (we) agree to release, hold harmless and indemnify the coaches and organizers of the team, the organizers of the contests, leagues, and tournaments, the other schools involved in the contests, leagues, and tournaments, and all of the other schools employees, trustees, agents, contractors, officers, organizers, volunteers, and other representatives from all claims for any injury or damage resulting from any cause which arise out of participation in or travel to and from these activities. This release is binding as to any other persons, including family members, heirs, and executors. If I am signing on behalf of a minor, I recognize that I may not release any claim the minor may have. However, I accept full responsibility for all medical expenses and claims incurred as a result of the minor s participation in or travels to and from ultimate activities. By signing below I authorize the provision of medical or emergency treatment for my child if (s)he should become injured while under the supervision of the afore mentioned coaches, in the event that a parent or guardian cannot be reached. I also agree to release, hold harmless and indemnify the coaches and organizers of the team, the organizers of the contests, leagues, and tournaments, the other schools involved in the league and all of the other schools employees, trustees, agents, contractors, officers, organizers, volunteers, and other representatives for any claims brought by the minor. I (we), the undersigned, have carefully read and understand the Participation Agreement & Release and agree it is binding upon me (us). Player Agreement Parent Agreement Date Date

4 What can happen if my child keeps on playing with a concussion or returns too soon? Athletes with the signs and symptoms of concussion should be removed from play immediately. Continuing to play with the signs and symptoms of a concussion leaves the young athlete especially vulnerable to greater injury. There is an increased risk of significant damage from a concussion for a period of time after that concussion occurs, particularly if the athlete suffers another concussion before completely recovering from the first one. This can lead to prolonged recovery, or even to severe brain swelling (second impact syndrome) with devastating and even fatal consequences. It is well known that adolescent or teenage athletes will often fail to report symptoms of injuries. Concussions are no different. As a result, education of administrators, coaches, parents and students is the key to studentathlete s safety. If you think your child has suffered a concussion Any athlete even suspected of suffering a concussion should be removed from the game or practice immediately. No athlete may return to activity after an apparent head injury or concussion, regardless of how mild it seems or how quickly symptoms clear, without medical clearance. Close observation of the athlete should continue for several hours. The new Zackery Lystedt Law in Washington now requires the consistent and uniform implementation of long and well-established return-to-play concussion guidelines that have been recommended for several years: a youth athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time and may not return to play until the athlete is evaluated by a licensed heath care provider trained in the evaluation and management of concussion and received written clearance to return to play from that health care provider. You should also inform your child s coach if you think that your child may have a concussion. Remember it s better to miss one game than miss the whole season. And when in doubt, the athlete sits out. For current and up-to-date information on concussions you can go to: Student-athlete Name Printed Student-athlete Signature Date Parent or Legal Guardian Printed Parent or Legal Guardian Signature Date

5 Scholarship Form for GHS Frisbee Spring 2017 Player s Name: Parent s Name: Contact Number: in case follow up questions occur. I would like a: partial full (circle one) scholarship for this season. I would like a scholarship for the following amount: My scholarship is to cover the following fees (mark all that apply with X, those in italics are optional for JV players): Girls Dues (Fields, Supplies, Coach CPR Training, Tournament Fees, Coaching Stipends) $ (or $130 for practice player) Purple Jersey (w/ individual name and number) $35 White Jersey (w/ individual name and number) $35 Shorts (w/ individual number) $28 All scholarships will be reviewed on an individual, rolling basis and the coaching staff may request more information before making a determination.