Join us on Friday, December 1st, 2017 for our First Annual Dodgeball Tournament

230p-6p

Feature Game at 545p 1st Place team vs. Teachers

Games will start immediately after school

Form your OWN TEAM or Register individually, you get to choose.

Must have 10 people to Register as a team, otherwise register as an individual and you will be placed on a team.

$10.00 per person

Don’t want to play, but would like to watch you can do that too for $3.00 for the entire duration of the event.

SNACK STAND AND BASKET RAFFLE WILL TAKE PLACE DURING THE TOURNAMENT

Teams and Individuals must be paid and registered by Friday, November 17th. Registrations received after this date will be accepted only if space allows.

Any questions contact Cathie Hill 610-349-2886 or email:

This event is taking the place of the Middle School March which was the only Large Fund Raiser the PTFS would run each year. Your support is needed to make this event a success and to be able to provide the Students and Staff of the UPMS additional support for supplies and events the PTFS sponsors each year.

UPMS PTFS – 1st Annual Dodgeball Tournament – December 1, 2017 230-6p – UPMS Gym

Dodgeball Team/Individual Registration Form –

Registration Deadline is Friday, November 17, 2017

Team/ Name: (optional) ______

All Team Names must be School/District Appropriate

Please return this registration form, along with $10.00 per person Registration Fee and all signed waivers (one for each player) together to the office of your child’s school, marked PTFS Dodgeball Tournament. Life Bands can be purchased the day of the Tournament (Max 1 per person per game $1.00 each)

A signed consent waiver form is required for each player and should be attached to this form.

TEAM ROSTER:

  1. Player Name: ______Grade: ______
  2. Player Name: ______Grade: ______
  3. Player Name: ______Grade: ______
  4. Player Name: ______Grade: ______
  5. Player Name: ______Grade: ______
  6. Player Name: ______Grade: ______
  7. Player Name: ______Grade: ______
  8. Player Name: ______Grade: ______
  9. Player Name: ______Grade: ______
  10. Player Name: ______Grade: ______

Format: The tournament will be double elimination. Brackets will be determined by a random drawing. Student teams may be all male, all female, or coed. Team Members may be a mix of 6-8th Graders or all one grade level. Students may have a theme for their team and use school appropriate costumes.

Entry Fee: $10.00 per person, and due no later than Friday, November17, 2017.

MAKE CHECKS PAYABLE TO UPMS PTFS, Sorry, no refunds.

PARENT VOLUNTEER OPPORTUNITIES

Tournament Parent Volunteer: Printed name: ______

Volunteer contact: Cell Phone # ______

Email ______

Times Available:

Prior to Event (picking up items for event) ______

Day of Event:

______130 to 230p____230 to 330p____330 – 430p____430-530p

______530 to 630p____630- End (730-8p)

I would like to donate an item towards the Basket Raffle: ______

Any Questions or for pick up Raffle contact Cathie Hill 610-349-2886 or email:

UPMS – PTFS – 1st Annual Dodge Ball Tournament

December 1, 2017

UPMS Gym

Parental Consent/Waiver and Media Release Form

Part 1 - Please read this information carefully and be aware that in signing up and participating in this program/activity, you will be expressly assuming the risk and legal liability and waiving and releasing all claims for injuries, damages or loss which your minor child/ward might sustain as a result of participating in any and all activities connected with and associated with this program/activity. I recognize and acknowledge that there are certain risks of physical injury to participants in this program/activity, and I voluntarily agree to assume the full risk of any injuries, damages or loss, regardless of the severity, that my minor child/ward may sustain as a result of participating in any and all activities connected with or associated with this program/activity. I further agree to waive and relinquish all claims my minor child/ward may have (or accrue to my child/ward) as a result of participating in this program/activity against the Upper Perkiomn School District, including their agents, officials, volunteers, employees and sponsors. I do hereby fully release and forever discharge the Upper Perkiomen School District from any and all claims for injuries, damages or loss that my minor child/ward may have, or which may accrue to my minor child/ward and arising out of, connected with, or in any way associated with this activity.

Part 2 Before, during and after this event in the spirit of celebrating and sharing, those present at this event and others may choose to provide comments, photos,

videos,etc. to the general public or specific audiences via social media. Additionally, requests may be received from the news media or professional persons to interview, photograph, and/or film students for news publications, television or radio broadcasts, UPMS Tribe TV, District Website or for various publications and brochures. I acknowledge and grant permission that my minor child/ward may be the subject of publicity including being interviewed, photographed, and/or filmed.

Student’s name (please print) ______Grade: ____

Parent or legal guardian name (please print) ______

Parent contact phone number day of event: ______

Parent contact phone number prior to event: ______

Parent or legal guardian signature ______Date signed_____