Upper St. Clair Hockey Association Dear Hockey Family, It s time to prepare for the 2014-2015 high school hockey season. The Upper St. Clair Hockey Association (USCHA) is now registering players in 7 th & 8 th grades for the Bantam Middle School Division (6 th Graders with a 2002 birth year players may be eligible please see below). This note provides important information regarding registration, tryouts and fees. Registration Registration of your player must take place on the web for the team on which he or she hopes to play. You can complete the form directly on the website and submit (www.uschockey.org/registration). The forms will then be present on the day of your try out. The following items must be received for complete registration: Upper St. Clair Hockey Association 2014-2015 Registration Form completed online USA Hockey Consent to Treat / Medical History Form on the website USA Hockey Code of Conduct Form - on the website A copy of the player s birth certificate is required, if not already in our files. USA Hockey Registration for the 2014-2015 season is not available yet but will be required prior to the start of the season in the fall. Two separate checks payable to Upper St. Clair Hockey Association as follows: Middle School: Tryout fee of $50 Commitment fee of $300 to be credited against the total annual fee. The above items are required before the player can participate in any on-ice activities, including tryouts. Annual Fees Middle School: Annual Fee of $1,400 (goalies $800). $50 tryout fee & $300 commitment fee are due at registration. If the player accepts their roster position then ALL $300 is credited to the annual fee. Four (4) monthly payments towards the annual fee are due by the first day of September 2014, October 2014, November 2014 and December 2014. For your convenience, the cost of socks is included in all registration fees. Players selected for any of the teams will be required to purchase USC home and away jerseys if they do not already own them. FUNDRAISERS WILL BE OFFERED TO REDUCE THE ANNUAL FEES FOR THE PLAYERS. Registration of your player must take place on the web for the team on which he or she hopes to play. You can complete the form directly on the website and submit (www.uschockey.org/registration).
Upper St. Clair Hockey Association Tryouts Under PIHL rules, for a player to be eligible for the Bantam Middle School Division players must have a birth year of 2000 or 2001. Players with a birth year of 2002 can be eligible for the Bantam division but must sign a waiver to play up. Please carefully consider your player s ability and experience, in addition to their school grade and age, to determine the appropriate tryout level. To be placed on a team at a particular level, your child must participate in a tryout for that level Tryouts for the Bantam Middle School team will be held at the Ice Castle Rink on the following dates: Level Day Date Time Bantam Wednesday March 26 th 6:30 7:30 pm Bantam Thursday March 27 th 5:30 6:50 pm Call backs will be scheduled if needed. All players should be at the rink one hour before the first scheduled tryout to check-in and be assigned a number. Complete registration paperwork must be presented and verified before they will be allowed on the ice. It is the player s responsibility to know the date and time to report next. At the discretion of the coaches, supplemental tryouts may be conducted. We are looking forward to another exciting season for the Panthers. One of the best ways to assure a successful and competitive program is to have strong participation at all levels. Please encourage your friends to register and tryout. If you have any questions or scheduling conflicts, please call Pete Gialames at (412) 401-7937 or email to pkhockey@gmail.com Follow the Panthers all season for schedules, scores, stats and announcements on their website:www.uschockey.org. Sincerely, Upper St. Clair Hockey Association Pete Gialames President
Upper St. Clair Hockey Association Registration Checklist Submit the following: Association Registration Form Completed Online www.uschockey.org/registration USA Hockey Consent to Treat/Medical History Form USA Hockey Code of Conduct Form Birth certificate copy (if not already on file) Tryout fee separate check payable to Upper St. Clair Hockey Association Commitment fee deposit check payable to Upper St. Clair Hockey Association 2002 Players MUST fill out the PIHL Waiver Form USA Hockey Individual Membership Registration (IMR) form after online registration. Completed PIAA Physical Form or Recertification.
USA HOCKEY PARTICIPANT CODE OF CONDUCT NAME: To be read and signed by you as a member of Team: Participating in USA Hockey for the season. 1. No swearing or abusive language on the bench, in the rink, or at any team function. 2. No lashing out at any official no matter what the call is. The coaching staff will handle all matters pertaining to officiating. 3. Anyone who receives a penalty will skate directly to the penalty box. 4. Fighting will not be tolerated. Fighting will result in an appearance before a Discipline Committee. 5. There will be no drinking, smoking, chewing of tobacco or use of illegal substance at any team function. 6. I will conduct myself in a befitting manner at all facilities (ice rink, hotel, restaurant, etc) during all team functions. 7. Any player or team official who cannot abide by these rules or violates them will be subject to further disciplinary action. Signed: Date: Form 1-P Rev 02/09
USA Hockey Consent To Treat/Medical History Form This is to certify that on this date, I, as parent or guardian of, (athlete participant), or for myself as an adult participant, give my consent to USA Hockey and its medical representative to obtain medical care from any licensed physician, hospital, or clinic for the above mentioned participant, for any injury that could arise from participation in USA Hockey sanctioned events. If said participant is covered by any insurance company, please complete the following: Insurance Company: Policy Number: Parent/Guardian/Adult Participant Signature: Date: Excess accident insurance up to $25,000, subject to deductibles, exclusions and certain limitations, is provided to all USA Hockey registered team participants. For further details visit usahockey.com or contact USA Hockey at (719) 576-USAH. EMERGENCY CONTACT Name: Phone: Address: Physician s Name: Phone: Hospital of Choice: COMPLETION OF MEDICAL HISTORY INFORMATION BELOW IS OPTIONAL MEDICAL HISTORY If the answer to any of the following questions is yes, please describe the problem and its implications for proper first aid treatment on the back of this form. Head Injury (concussion, skull fracture) Fainting spells Convulsions/epilepsy Neck or back injury Asthma High blood pressure Kidney problems Hernia Heart murmur Have you had (or do you currently have) any of the following? Have you had a recent tetanus booster? Yes No If yes, when? Are you currently taking any medications? Yes Allergies Diabetes Other No If yes, please list all medications on back. Has a doctor placed any restrictions on your activity? Yes No If yes, please explain on back. 3C Rev 2/09
PIHL Risk Acknowledgement and Liability Waiver To be completed for each second-year Pee Wee player playing on a PIHL Middle School/Bantam team. Association Name: Season: Name of Participant (print): Birthdate: I hereby acknowledge that I permit my child to participate at an age level that is one year in age above the USA Hockey recommended guidelines. I understand and appreciate that the risk of injury may be greater at this level and that the risk of injury from hockey may be significant, including the potential for permanent paralysis or death. I understand that while particular rules, and personal discipline may reduce this risk, the potential for serious injury still exists. By my childʼs participation, I KNOWINGLY ASSUME ALL SUCH RISKS, BOTH KNOWN AND UNKNOWN. Further, I agree to indemnify and hold the association listed above; any PIHL officers and USA Hockey, Incorporated, harmless from any and all liability, loss, expense, attorneyʼs fees or claims for injury or damages caused as a result of my request. I understand that the agreement by my association to allow my child to participate on the Middle School/Bantam team is probationary and my association reserves the right to reverse its decision if it is felt that my child is not capable of participating at this level. This may not occur until after his/her performance is observed in actual game situations by the coaches and/or the association coaching director. I understand and agree to respect all of the conditions listed above for participation with this USA Hockey team. Participant Signature: Date: Parent/Guardian Name (print): Parent/Guardian Signature: Date: