WENDELL RECREATION DISTRICT

REGISTRATION & WAIVER OF PARTICIPATION FORM

NAME:______BOY_____ GIRL______

ADDRESS:______PHONE: ______

DATE OF BIRTH:______GRADE______SHIRT SIZE:______

Check Sport

$25___ Wrestling (grades K-6) $35 ___5th grade Boys Basketball $35 ___6th grade Girls Basketball

$30___Jr. Co-ed Basketball (grades 3-4) $35 ___ 5th grade Girls Basketball $35 ___6th grade Boys Basketball

In the consideration of the opportunity afforded my son or daughter to participate in recreational activities sponsored and supervised by the Wendell Recreation District, and in recognition of possible injuries to which (I, he, she) may voluntarily subject ( myself, himself, herself) by virtue of such participation, I hereby knowingly, freely, and voluntarily waive any right or cause of action, of any nature whatsoever, occurring as a result of such activity from which liability could accrue to the Wendell Recreation District, it's employees, agents, or directors in any capacity.

I further recognize that the Wendell Recreation District has requested that ( I, my child,) have a complete physical examination by a licensed physician prior to engaging in any of the above mentioned activities, and that the said District will rely on my statement, which I hereby make, that the physical condition of ( myself, my child) is not impaired and will not be impaired by the rigors of the above listed activity.

Signed ______

The above named participant is covered by medical insurance.

Name of Company______Policy # ______

MAKE CHECKS PAYABLE TO: WENDELL RECREATION DISTRICT.

Parent’s Code of Ethics

· I will encourage good sportsmanship by demonstrating positive support for all players, coaches and officials at every game, practice or other youth sporting event.

· I will place the emotional and physical well being of my child ahead of my personal desire to win.

· I will insist that my child play in a safe and healthy environment.

· I will support coaches and officials working with my child, to encourage a positive and enjoyable experience for all.

· I will remember that the game is for youth – not adults.

· I will do my very best to make youth sports fun for my child.

· I will ask my child to treat other players, coaches, fans and officials with respect regardless or race, sex, creed or ability.

· I will help my child to enjoy the youth sport experience by doing whatever I can, such as being a respectful fan, assisting with coaching, or providing transportation.

· I realize and agree to the policy that if I do not uphold these principles, I may be banned from attending practices and/or games in which my child participates based on a decision solely made by the board of the Wendell Recreation District.

Printed Name ______


Signature ______Date ______