The Louisiana Tigers Youth Organization

The Louisiana Tigers Youth Organization 2015 Youth Football Registration Packet Jason L. Fisher President Christopher McKinley, Sr. Vice President John Fisher, Sr. Vice President www.thelouisianatigers.com Instagram @thelouisianatigers

Dear Tiger Family, Welcome to the Louisiana Tigers Youth Organization, an organization that prides itself on instilling the basic fundamentals of football and cheer while preparing each member for the next level. Our wellexperienced coaching staff has been working very hard to build a strong program to develop great student-athletes. The mission of the Louisiana Tigers Youth Organization is to be a non-profit organization that provides programs and services to build leadership, improve academic skills, increase self-esteem and motivation, and build strong STUDENT-ATHLETES in Louisiana area students. Our mission defines expectations both on the field and off, and the Louisiana Tigers Youth Organization is committed to the excellence in athletics as part of a larger commitment to excellence and education. I have always believed that there is more to be learned from football than football itself. Success is not measured in wins and losses but by the team s ability to exemplify the core values of respect, integrity, cooperation, self-discipline, sportsmanship and citizenship. Good sportsmanship is an essential part of the Louisiana Tigers Youth Organization and it is our goal to have the Louisiana Tigers recognized for our sense of fair play, outstanding effort, and character. I ask that players, coaches, parents and spectators uphold these values at all of our events. Parents can help model the type of behavior we have come to expect from our student-athletes. In this registration packet you will find the necessary information about the upcoming 2015 season along with the forms that need to be completed and returned before your child is eligible to participate, which must be turned in by June 1, 2015. The following is a checklist of the items and forms that need to be completed and turned in: Registration Form Football Player Identification Card Code of Conduct 2015 Media Release Form LHSAA Physical Form (completed by a licensed physician) Two (2) copies of birth certificate Two (2) recent color photos Thank you for choosing our organization and we look forward to having a very successful season. I am confident that the 2015 season will be a great success for the Louisiana Tigers! Sincerely, Jason L. Fisher Louisiana Tigers Youth Organization President

Registration Fee The football registration fee is $185.00 per child. The multiplayer family discount is $20 per extra family member for multiple registrants in the same immediate family. Payments are due by June 1, 2015 and late fees will be accessed after this date. ALL FEES ARE NON-REFUNDABLE The registration fee includes: Two (2) game jerseys One (1) pair of game pants One (1) compression shirt (to be worn on game day under uniform) Player insurance Tiger Camp Payments All payments can be made via cash, money orders or PayPal using the payment method on the website, www.thelouisianatigers.com. Money orders should be made payable to the Louisiana Tigers Youth Organization. PAYMENT DOES NOT GUARANTEE PLAYING TIME Parent & Player Responsibilities Parents and players are responsible for the following: Tiger Camp t-shirt ($10.00) Shoulder pads White Helmet with white facemask (logos will be applied by organization) White practice pants and pads Black cleats Mouth piece Practice jersey Practice jerseys are available at The Sport Connection, located at 11713 Plank Rd., Baton Rouge, LA 70811, (225) 775-0953. Each team has been assigned a different color practice jersey and it is MANDATORY that each player has the correct jersey color which is listed below: A Team Gold jersey w/ navy blue numbers B Team Navy blue jersey w/ gold numbers C Team White jersey w/ navy blue numbers D Team Columbia blue jersey w/ gold numbers

Practice The first day of practice is June 15, 2015 and the first day of full pads is August 1, 2015. Practice will be held three (3) to four (4) times a week from 5:45 p.m. 7:45 p.m. at the Flanacher Road BREC Park located at 864 E. Flanacher Rd., Zachary, LA 70791. Sports physicals are required prior to the first full gear practice, August 1, 2015, - for insurance reasons, there are no exceptions. All physicals must be completed and dated on or after January 1, 2015. Prior year physicals will not be accepted. Playing League The Louisiana Tigers Youth Organization will be participating in the River Parish Youth Football and Cheer League. Information about the league can be found on our website, www.thelouisianatigers.com. Volunteering and Fundraising The Louisiana Tigers Youth Organization would like to remain cost efficient while providing each member with a first class experience. Please understand that your child's participation in the Louisiana Tigers Youth Organization is contingent upon your participation as an adult volunteer. We will host a minimum of four (4) home games and ALL parents are required to participate. Game day volunteers, concession helpers, and special event helpers are critical to the success of our program. Game day activities include, but are not limited to: gate collector, chain gang, announcer, game clock, cleanup crew, and concession. We will have a minimum of one (1) major fundraiser for the 2015 football season and it is MANDATORY that all players participate. Sign up for these activities will take place once the game schedule is known and at a later date closer to the start of the season.

Louisiana Tigers Youth Organization Registration Form 2015 Participant Information Name of Birth Age Grade (as of 8/1/15) Address City, State, Zip School _ *********************************************************************************************************************************** Please circle one: T-Shirt Size - Youth / Adult SM Med L XL Parent(s)/Guardian(s) Information Mother s Name Phone E-mail Address Father s Name Phone E-mail Address *********************************************************************************************************************************** IN CASE OF EMERGENCY Name _ Phone *************************************************************************************************************************************** Participant s Medical Conditions: *************************************************************************************************************************************** CONSENT AND RELEASE FORM I hereby give approval for the participation of my child in the Louisiana Tigers Youth Organization football season and assume all risks and hazards related to such participation, including transportation to and from all activities. I waive, release, absolve, indemnify and agree to hold harmless any facility and the Louisiana Tigers Youth Organization, affiliated associations, organizers, officers, coaches, parents, participants and officials from any claim arising out of injury to my child. I hereby give permission for any game facility and/or the Louisiana Tigers Youth Organization to obtain medical services for my child in case of medical emergency or injury. Parent/Guardian Signature PLAYERS CODE OF CONDUCT I hereby pledge to maintain a positive attitude about my youth sports experience and accept responsibility for my participation by following this Players Code of Conduct Pledge. Violation of this code may result in suspension or termination. I will encourage good sportsmanship from fellow players, coaches, referees, and parents at every game and practice, and will exhibit good sportsmanship to make this an enjoyable experience. I understand that I am a STUDENT-ATHLETE and will strive for academic excellence by maintaining a GPA of 2.3 throughout the school year. I am responsible for attending, and being on time for, ALL practices and games, and will notify my coach with a VALID excuse if I cannot. I understand that three (3) unexcused absences may result in suspension or termination. I understand that I am responsible for my actions on AND off the field. I will do my best to listen and learn from my coaches and will treat my coaches, other players, fans, and referees with respect. PARENTS CODE OF CONDUCT I hereby pledge to provide positive support, care and encouragement for each child participating in this youth sports experience by following this Parents Code of Conduct. Violation of this code may result in suspension or termination. I will encourage good sportsmanship by demonstrating positive support for all players, coaches, and referees, at every game and practice. I will place the emotional and physical well being of my child ahead of a personal desire to win. I will support coaches and referees working with my child, in order to encourage a positive and enjoyable experience for all. I will ask my child to treat other players, coaches, fans and referees with respect and will remember that the game is for the youth. I will not engage in arguments, use foul or abusive language, or exhibit any acts of verbal or physical aggression. I promise to help my child enjoy this youth sports experience by doing whatever I can, such as being a respectful fan and a positive supporter. Player Signature Parent/Guardian Signature

FOOTBALL PLAYER IDENTIFICATION CARD TEAM D Team C Team B Team A Team AGE GROUP 6 Under 8 Under 10 Under 12 Under BIRTH CERTIFICATE NUMBER NOT ELIGILBE TO PARTICIPATE UNLESS THIS DOCUMENT IS COMPLETED IN FULL. Any False or questionable information SHALL be addressed only with an Original Birth Certification with the original State Seal affixed. This documentation will be proved within 48 Hours to the League or the questionable player, team and Head Coach will forfiet all games and be disqualified. PLAYER INFORMATION Of Birth Player Full Name Address Phone Number City State Zip Code School Attending Grade We the undersigned, hereby certify that the current photograph and other information including the Birth Certificate with the Original State Seal affixed and report card are of the same person. SIGNATURES Parent Head Coach Org. President League Rep. Attach a current photograph below and a copy of the Birth Certification and last years Report Card.

CODE OF CONDUCT Louisiana River Parish Youth Football and Cheer League, Inc. (Here and after, The League, will not tolerate use of profanity, use of controlled substances, confrontational behavior, intimidation of any form, either on the field or off. Everyone will abide by a Code of Conduct which is not limited to these provisions. 1. Not criticize the players/cheerleaders or coaches in front of the other spectators in the stands, but reserve constructive criticism for later, in private. 2. Accept decisions of the game officials (including referees and coaches) on the field as being fair and called to the best ability of said officials. Not interfere or interrupt the coaching staff before, during or after games or at practice. 3. Not criticize an opposing team, its players, coaches, or fans by word of mouth or by gesture. 4. Refrain from using physical or verbal abuse or profane language at any game, practice field, or any functions. 5. Abstain from being under the influence of or in possession of and/or drinking alcoholic beverages and the possession or use of any illegal substance on both the game and practice fields. 6. Not be allowed on the sidelines during a game. 7. Not express complaints about coaches in stands or in front of or around the children after a game or practice. All players playing time shall be earned in the opinion of the coaching staff whose decisions are final. Athlete s will: show sportsmanship, ethical conduct and fair play. Show courtesy to opponents and officials. Athlete s will not: Use profanity or talk trash before, during or after any game. Use drugs, alcohol, or tobacco. Parents will: Support their child s team and show ideals of sportsmanship, ethical conduct and fair play. Show courtesy to opponents and officials. Direct constructive criticism to the team officials and work toward a positive result. Parents will not: Criticize officials, direct abuse or profane language toward them. Undermine the authority of the coach or administration. Intrude onto the field, stand on the sideline, or yell from the bleachers at anyone or to the coaches, referees or administration. VIOLATIONS The violations are not limited to and the procedure is as follows: 1. Any person who violates the code of conduct or becomes a nuisance will be asked to leave by the Field Marshall or League Authority and can be suspended from all team activities. 2. If the violator fails to leave upon request, it may jeopardize your child s participation in the team activities. 3. Field Marshalls/League Administrators are instructed to remove players from the activity for 8 minutes on the First Offense. Upon a Second Offense, the player will be ejected from the game. After the Third Offense, the player is removed from the team for remainder of the year. 4. Adults are removed from the contest or activities are banned for 1 year from the date of the incident. 5. The Field Marshall/League Authority along with the Board of Directors will decide if the duration of the suspension is to be longer or if the child will be dropped from the program. All these decision are final. My signature means I have read the CODE OF CONDUCT and understand that any violation may jeopardize my, and as a last resort your participant s participation with the League. _ Participants/Volunteer Name (Print) Participants/Volunteer Name (Signature) Parents Name (Print) Parents Name (Signature)

2015 Louisiana Tigers Youth Organization Media Release Form Participants Name: Parent/Guardian Name: Relationship: Often, our football players and cheerleaders are photographed either at practice or during games/events by parents, friends, and Louisiana Tiger board members in order to preserve great moments in our children's lives, as well as to help promote the organization. It has been the practice of the Louisiana Tigers Youth Organization to ask for and collect copies of such photographs/videos in digital and other formats to display on our team website www.thelouisianatigers.com, or for inclusion for the end of season banquet decorations and entertainment. By completing the form below, you will give the Louisiana Tigers Youth Organization permission to display such photographs/video images of your child described in the preceding paragraph for as long as the organization deems appropriate, or until you have notified the organization in writing that you no longer wish to give said permission. The person named below gives the Louisiana Tigers Youth Organization permission to allow the use of photographs and/or video images of his or her child in connection with the events and activities involving the Louisiana Tigers football and cheer squads. I consent to the use of his/her name and/or photograph in connection with the production, exhibition, distribution or other use of any photographs or motion video. I agree that his/her participation is voluntary, and without consideration or compensation. If, at any time, I do not want my child to participate in this activity I will notify the Louisiana Tigers Youth Organization Secretary in writing. Parent/Guardian Signature: : / /

LHSAA MEDICAL HISTORY EVALUATION IMPORTANT: This form must be completed annually, kept on file with the school, & is subject to inspection by the Rules Compliance Team. Please Print Name:_School: Grade: : Sport(s): Sex: M / F of Birth: Age: Cell Phone:_ Home Address: City: State: Zip Code:_Home Phone: Parent / Guardian: Employer:Work Phone: FAMILY MEDICAL HISTORY: Heart Attack/Disease Stroke Diabetes Has any member of your family under age 50 had these conditions? Whom Whom Sudden Death High Blood Pressure Sickle Cell Trait/Anemia Arthritis Kidney Disease Epilepsy Whom ATHLETE S ORTHOPAEDIC HISTORY: Has the athlete had any of the following injuries? Head Injury / Concussion Neck Injury / Stinger Shoulder L / R Elbow L / R Arm / Wrist / Hand L / R Back Hip L / R Thigh L / R Knee L / R Lower Leg L / R Chronic Shin Splints Ankle L / R Foot L / R Severe Muscle Strain Pinched Nerve Chest Previous Surgeries: ATHLETE MEDICAL HISTORY: Has the athlete had any of these conditions? Heart Murmur / Chest Pain / Tightness Asthma / Prescribed Inhaler Menstrual irregularities: Last Cycle: Seizures Shortness of breath / Coughing Rapid weight loss / gain Kidney Disease Hernia Take supplements/vitamins Irregular Heartbeat Knocked out / Concussion Heat related problems Single Testicle Heart Disease Recent Mononucleosi High Blood Pressure Diabetes Enlarged Spleen Dizzy / Fainting Liver Disease Sickle Cell Trait/Anemia Organ Loss (kidney, spleen, etc) Tuberculosis Overnight in hospital Surgery Prescribed EPI PEN Allergies (Food, Drugs) Medications List s for: Last Tetanus Shot: Measles Immunization: Meningitis Vaccine: PARENTS WAIVER FORM To the best of our knowledge, we have given true & accurate information & hereby grant permission for the physical screening evaluation. We understand the evaluation involves a limited examination and the screening is not intended to nor will it prevent injury or sudden death. We further understand that if the examination is provided without expectation of payment, there shall be no cause of action pursuant to Louisiana R.S. 9:2798 against the team volunteer healthcare provider and/or employer under Louisiana law. This waiver, executed on the date below by the undersigned medical doctor, osteopathic doctor, nurse practitioner or physician s assistant and parent of the student athlete named above, is done so in compliance with Louisiana law with the full understanding that there shall be no cause of action for any loss or damage caused by any act or omission related to the health care services if rendered voluntarily and without expectation of payment herein unless such loss or damage was caused by gross negligence. Additionally, 1. If, in the judgment of a school representative, the named student-athlete needs care or treatment as a result of an injury or sickness, I do hereby request, consent and authorize for such care as may be deemed necessary...yes No 2. I understand that if the medical status of my child changes in any significant manner after his/her physical examination, I will notify his/her principal of the change immediately..yes No 3. I give my permission for the athletic trainer to release information concerning my child s injuries to the head coach/athletic director/principal of his/her school..yes No 4. By my signature below, I am agreeing to allow my child s medical history/exam form and all eligibility forms to be reviewed by the LHSAA or its Representative(s).. Yes No Signed by Parent Signature of Parent Typed or Printed Name of Parent II. COMPLETED ANNUALLY BY MEDICAL DOCTOR (MD), OSTEOPATHIC DR. (DO), NURSE PRACTITIONER (APRN) or PHYSICIAN S ASSISTANT (PA) Height GENERAL MEDICAL EXAM : Norm Abnl ENT Lungs Heart Abdomen Skin Hernia (if Needed) COMMENTS: Weight Blood Pressure OPTIONAL EXAMS: VISION: L: R: Corrected: DENTAL: 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 31 30 29 28 27 26 25 24 23 22 21 20 19 18 17 From this limited screening I see no reason why this student cannot participate in athletics. [ ] Student is cleared [ ] Cleared after further evaluation and treatment for: [ ] Not cleared for: contact non-contact Printed Name of MD, DO, APRN or PA Revised 5/14 Signature of MD, DO, APRN or PA Pulse_ ORTHOPAEDIC EXAM : Norm I. Spine / Neck Cervical Thoracic Lumbar II. Upper Extremity Shoulder Elbow Wrist Hand / Fingers III. Lower Extremity Hip Knee Ankle Abnl of Medical Examination This physical expires one year on the last day of the month that it was signed and dated by the MD, DO, APRN or PA.