WALTON-VERONA YOUTH FOOTBALL ASSOCIATION 2018 REGISTRATION FORM

Transcription

1 WALTON-VERONA YOUTH FOOTBALL AOCIATION 2018 REGITRATION FORM Pleae circle appropriate team / age for fall 2018: Refer to Helpful Fact and Tip heet for cut off date for each team. FLAG TARTER PEEWEE / MIDGET JUNIOR YOUTH / JUNIOR DATE OF BIRTH: TREET ADDRE: CITY: TATE: ZIP: CHOOL PLAYER ATTEND: GRADE FOR FALL 2018: PARENT / GUARDIAN #1 HOME PHONE: CELLPHONE: Can you receive text meage? YE Q NO PARENT / GUARDIAN #2 HOME PHONE: CELLPHONE: Can you receive text meage? YE NO DO YOU HAVE ADDITIONAL PARENT / GUARDIAN WHO NEED TO BE ON CONTACT LIT? YE* \~_ NO Q *lf ye, pleae add to the back of thi page. FEE: PLEAE MAKE CHECK PAYABLE TO WVYFA $75.00 for all football player for the 2018 eaon. ($25 DICOUNT BEFORE JUNE 18 th ) WVYFA ue only: ] Fee Paid ] Birth Certificate Regitration form 1 Player phyical (Valid through Nov 30th) Peronal Inurance Coverage ~\ NKYFL Contract Emergency contact info ~] Player photo for NKYFL WVYF Code of conduct ] Ticket ditributed - # given: WVYFA Releae, Waiver & Aumption of Rik form [ZZI Ticket turned in WV Waiver roter FOOTBALL PLAYER COT $75.00 $ TOTAL PAID $ CHECK CAH DIGITAL CHECK NUMBER

2 WALTON-VERONA YOUTH FOOTBALL AOCIATION ADDITIONAL INFORMATION ' Ha your child(ren) played for another team other than WVYFA in the NKYFL? YE Q NO Q If ye, pleae lit team, approx. date and reaon for leaving: Do you reide within Walton-Verona chool ditrict? YE [ NO PERONAL INURANCE COVERAGE INURANCE CARRIER: POLICY NUMBER: GROUP NUMBER: IN PHONE #: PLAYER CHOOL: PLEAE LIT PLAYER() COVERED BY THI POLICY: Thi information will be hared with WVH. "Thi information i lited on another player' form. EMERGENCY CONTACT INFORMATION PLEAE LIT PLAYER() INCLUDED FOR THI INFO: *Thi information i lited on another player' form. Pleae note we will tart by contacting thoe lited on the regitration form firt. If they are not reachable, we will contact the peron lited below. Check the box if you want u to contact the peron lited below firt: EMERGENCY CONTACT #1 HOME PHONE CELL PHONE: ADDRE: DENTIT PHONE:. PHYICIAN PHONE: KNOWN ALLERGIE/ LIMITATION:. PLAYER NAME/AGE: KNOWN ALLERGIE/ LIMITATION: PLAYER NAME/AGE:

3 WVYFA RELEAE / WAIVER / AUMPTION OF RIK AGREEMENT PLAYER NAME() / AGE: WHEREA, in conideration of allowing the above named participant() ("Minor()") to participate in the Walton-Verona Youth Football football or cheerleading program(), including intruction and coaching in football or cheerleading (the "Activitie"), ue of the premie upon which the Activitie will take place, and for other good and valuable conideration, the receipt and ufficiency of which i hereby acknowledged, the underigned parent and/or legal guardian of aid Minor() and /or natural and legal guardian of aid Minor, agree to the following: Minor and Parent (on behalf of Parent and Minor) waive for themelve and their executor, adminitrator, aignee or heir, any and all right and claim for damage, loe, demand and other action whatoever, which they, individually or a a whole, may have or which may arie againt WVYFA, the Northern Kentucky Youth Football League (NKYFL), the individual club compoing the NKYFL, the ponor, coache, officer, director, official, agent, employee, taff and volunteer of all of the aforementioned organization, and the owner and leor of any premie ued for the Activitie, hereinafter referred to collectively a "Releaed Partie", including but not limited to any and all injurie, damage or illnee uffered by the Minor and/or Parent, including thoe injurie, damage or illnee ariing out of or related to the negligent act of the Releaed Partie, which may, in any way whatoever, arie out of, be related to or be connected with the Activitie; the coure of intruction and/or coaching; the Premie, including any latent defect in the Premie; Minor and/or Parent' preence on or ue of aid Premie; and Minor and/or Parent' property whether or not entruted to the Releaed Partie. The Releaed Partie hall not be liable for, and Minor or Parent, on behalf of themelve and their executor, adminitrator, aignee or heir, hereby exprely releae and dicharge the Releaed Partie from any and all uch claim. Minor and/or Parent hereby exprely aume the rik of entering the Premie and of taking part in the Activitie, which include, but are not limited to, intruction, coaching and participating in football or cheerleading. Minor and/or Parent grant the WVYFA and NKYFL permiion to photograph / videotape minor for poible ue in brochure, video, web ite, new article, etc promoting participation in youth football and cheerleading program. It i agreed that talent fee will neither be ought nor given. Minor and/or Parent furthermore hereby acknowledge and agree that they have read, undertand and will at all time abide by the WVYFA and NKYFL rule, regulation, direction and procedure, including thoe of Related Partie. Thi intrument bind Parent, Minor and their executor, adminitrator, aignee or heir. I certify that I am a cutodial parent and have the aforementioned right to aign. Parent / Guardian ignature: Printed name: Date: WVYF CODE OF CONDUCT I have received, read and retained a copy of the Walton-Verona Youth Football Code of Conduct. Parent / Guardian ignature: Printed name: Date:

4 2018 WALTON-VERONA YOUTH FOOTBALL CODE OF CONDUCT The Athletic Code of Conduct outline the behavior that Walton-Verona Youth Football (WVYF) expect from it coache, player, and parent. Pleae read the following item to ee the type of behavior we expect from all participant at Walton-Verona Youth Football Event. Coache, parent and athlete are all eential participant in the ucce of our athletic program, but more importantly, they are the key to the healthy development of each young player who chooe to participate in football within Walton-Verona Youth Football Aociation. We want that experience to be a poitive one that foter the puruit of excellence in all facet of life. It i important to undertand that participation in Walton-Verona Youth Football i a privilege. Organized port provide the perfect arena to learn about life. What athlete experience and learn in that arena hould become part of a trong foundation from which to build the ret of their live. We look forward to your involvement in the Walton-Verona Youth Football program. Athlete' Code Athlete who participate in organized port have a tremendou opportunity for growth. Athlete develop their trength, coordination, endurance, and pecific kill related to the port they play. But athlete would be miing the greatet gift port have to offer if they limited themelve to phyical prowe. Athlete who gain the mot from port have allowed their mind and pirit, a well a their bodie, to grow a they experience the win and loe of organized port. Thoe who have challenged themelve to be the bet they can be, not jut in the game, but during practice a well, will develop characteritic they will ue throughout their lifetime. Athletic, if allowed, will teach young people about never giving up, about taking pride in all they do, about feeling joy or empathy for other, and about making friend. Mot of all, port will teach athlete to believe in themelve and their abilitie. Walton Verona Youth Football Code of Conduct for Athlete: I will alway be a good port, whether winning or loing. I will alway how repect for all player, coache, and official. I will never ue obcene language or geture. I will upport my team in a poitive way, whether playing or on the ideline. / I will undertand that I am a role model for other. / I will give my bet effort and attention at practice and during the game. / I will play fair, and follow the rule of the game. / I will repect all opponent and their effort. / I undertand that the amount of time I participate in each contet will be determined by the coach. / I will be humble and realize that my individual accomplihment are only poible becaue of my teammate. Coach' Code The role of a coach i unique and mot challenging becaue he or he i attempting to modify the behavior of both mind and body. The parent are depending on the coach for the welfare of the player a well a for developing proper attitude and phyical kill. The coach i in the poition to demontrate moral leaderhip during preurized and competitive ituation. The coach i in the unique poition of being liked, truted, and repected in an informal atmophere. At Walton-Verona, our coache are expected to accept the reponibility of furthering the development of a player on and off the field. Walton Verona Youth Football Code of Conduct for Coache: I will place the emotional and phyical well-being of my player ahead of any peronal deire to win. / I will remember to treat each player a an individual, remembering the large pread of emotional and phyical development for the ame age group. ^ I will do my very bet to provide a afe ituation for my player. I promie to review and practice the neceary firt aid principle needed to treat injurie of my player. I will do my bet to organize practice that are fun and challenging for all my player. I will enure that I am knowledgeable in the rule of each port that I coach, and that I will teach thee rule to my player.

5 / I will ue coaching technique appropriate for each of the kill that I teach. / I will remember that lama youth coach, and that the game i for the children, and not the adult. Parent' Code Parent are offered a rare opportunity a they allow their child to enter the world of port. Thi world provide the player with an arena for exercie, competition, and learning about life. It provide parent with the opportunity to teach, communicate, and build character and elf-eteem in their child. While winning a game can be exciting and inpirational, Walton-Verona parent are expected to help teach player that winning doe not define the importance or worth of the team or the individual player. Walton Verona Youth Football Code of Conduct for Parent: I will alway be upportive. / I will not coach from the ideline. / I will not yell negative remark at player, coache, other team, or referee. / I will upport the coaching taff. / I will alway have praie for my child' athletic performance. / I will help the athlete to et realitic goal. / I will provide a houlder to cry on when needed. / I will teach port etiquette and good portmanhip. / I will educate the athlete regarding team loyalty and reponibility. / I will help the athlete to communicate with the coaching taff in a poitive way. / I will follow the proper line of communication to reolve problem. / I will alway cheer the athlete and the team. I undertand that the coach will determine the amount of time my child participant. I will do my bet to realize that my child' hortcoming and accomplihment are not my own. Rule and Guideline > The line of communication to reolve problem will be: Player to coach or coach to player r Parent to coach or coach to parent If the above line of communication i not effective; Coach or parent to director of the board. > A meeting of all coache will be held to dicu and review policie. > Foul language and unportmanlike behavior will not be tolerated by coache, player or fan. Violator may be aked to leave the team and/or not permitted to attend game. > Each coach hould alo have a meeting with the parent of their player, to go over team rule, etc. Coache hould give each parent a monthly chedule of all practice and game. A copy of thi Code of Conduct can be found online at httd://wvvouthfootball.com/handout