ParklandYouthCenter Basketball Registration/Code of Conduct Form

Last Name: ______First Name: ______MI: ______

Address: ______Zip: ______

Phone: ______School: ______Grade: ______Birth Date: ______

Age: ______Sex (M/F) ___ Parents e-mail: ______

Father’s name: ______Mother’s Name: ______

Volunteer to Help: Coach: _____ Assistant: _____ Team parent: ______Other: ______

We Need Coaches and Volunteers!!!!!!!!!!! Must check:

In house Parkland REC League ______or Lehigh Valley Travel League ______or LV Boys JV Travel 3rd-8th ______

Registration Fee: Any returned checks $20 fee. No Refunds except for unforeseen circumstances!! Late fees after 10/16/17 are $20. Registering after 10/16/17 will not guarantee a team roster position.

Lost Jersey/Uniforms $30

$60for grades K – 2,$95 For Travel teams. No Refunds if player does not make Travel Team

$80 for Grades 3rd -8th$210 Family (3 or more)

$95 for 9th-12th

Mail form with check payable to PYC mail to: Michael Lahanas 2026 Sunrise Drive, Allentown, PA 18104

Parental Consent Form

Parent/Guardian:

As legal guardian of the player(s) named on this registration form, I/we hereby grant my/our full consent & approval for my/our child (ren) to participate as a team member in any PYC organizational activity during the current season. This includes but is not limited to the following: practices, games, fundraising, and transportation to and from games, practices, and other organizational events. By signing this document, I/we agree to abide by all the rules, regulations, and decisions of PYC and its respective sports leagues.

I/we, the undersigned, understand that there are certain risks of injury inherent in the practice and play of this sport, as well as in traveling and other related activities incidental to my/our child(ren)’s participation. I/we am/are willing to assume these risks on behalf of my/our child (ren). In addition to giving my/our full consent for my/our child(ren)’s participation, I/we do hereby release, waive, absolve, indemnify and agree to hold harmless the PYC Organization, its respective sports leagues, the Parkland School District, their officers, coaches, sponsors, organizers, directors, supervisors, officials, members, participants, and persons transporting my/our child(ren) to and from PYC activities, from any responsibility or liability for any claim for damages for injuries sustained by the player(s) listed on this registration form. This includes but is not limited to play, practice or activity associated with the PYC Organization or in traveling to and from the playing field, or place of activity at which any practice, game, exhibition or event may be conducted. I/we, the undersigned, assume all financial responsibility for payment of medical, dental expenses for the named player(s). The PYC Organization assumes no liability or costs in the event of injury, death or illness of any kind, due to participation in the PYC activities. I/we hereby certify that my/our child(ren) is/are fully capable of participating in the designated sport and that my/our child(ren) is/are healthy and has/have no physical/mental disabilities or infirmities that would restrict full participation in these activities, except as listed below:

I/we herby intend to be legally bound and this agreement shall bind my/our heirs, administrators, executors and assigns.

SignatureDateRelationship to Player

CODE OF CONDUCT

As a participant IN PYC sports, as a player, coach, or parent/guardian, I agree that I will adhere to the PYC mission statement by always demonstrating, during team practices and games, the highest level of sportsmanship. I will do this by avoiding the following behavior: 1. Abusive or excessive demeaning speech to players, parents, coaches or fans involved in practices or games 2. Abusive or excessively demeaning speech to umpires, referees, or other league sponsored officials 3. Demonstrating in any way an inability to control my temper 4. Any behavior in games or practices that would by reasonable standards misrepresents the desire of PYC to put forth a high standard of sportsmanship 5. The use of foul language, tobacco, or alcohol at games or practices. Please note that the use of tobacco and alcohol is strictly prohibited on school district and township property.

I have read the above mentioned criteria and I agree that I will, to the best of my ability adhere to its content. If I am found in violation of any of the above mentioned rules, I agree to remove myself from participating in PYC sponsored events.

SignatureParent /Guardian DateSignature of Player

Rev 7/28/2009 mm