Blowing Rock Parks and Recreation

2007 Youth Basketball Registration

Registration: September 10^th – October 15^th 2007

Birth Certificate is required with registration!

**Registration Fee: $30.00 Blowing Rock Taxpayer, $40.00 Non-Taxpayers**

(all Taxpayers must present a copy of their Tax Bill to receive the Taxpayers rates)

(Late Registration: additional $5 and child will be placed on a waiting list if no space is available)

Participant Name________________________Age on Oct. 15, 2007_____ Birthday__________

Mother/Guardian Name_____________________ Father/Guardian Name___________________

Address_______________________________________________________________________

Phone:(h) ___________________ Mother(w)______________ Father(w)___________________

Mother(cell)__________________Father(cell)_____________

Please indicate shirt size: Youth M___YL___ Adult S___AM____ AL___AXL___

LEAGUE: Please indicate the appropriate league for your child. League age is determined by your child’s age on October 15, 2007. Child must be league age by that date and not older than the league age on that date.

**Registration numbers will ultimately determine league break-downs. Adjustments to the following layout will be made accordingly if deemed necassary.

___Instructional (kindergarden-must be 5 years of age on 10/15/07)

___Pee Wee (1^st and 2^nd grade- must be 6 and no older than 7 on 10/15/07)

___Midget ( 3^rd and 4^th grade- must be 8 and no older than 9 on 10/15/07)

SCHOOL DISTRICT: Please indicate the school your child attends____________________

If different, please indicate the school district you RESIDE in__________________________

Which team would you prefer to have your child placed on, if given the option?

(please circle) 1. The district you reside in or 2. The school your child attends

Would you like to coach a 2007 Jr. NBA team? YES___ NO___ Contact name and # ________________________

Would you like to sponsor a 2007 Jr. NBA team? ($200.00) YES___ NO___Contact name and # ______________

Waiver and Release

I hereby give ________________ my permission to participate and be involved in Blowing Rock Parks and Recreation’s basketball program. By authorization, I hereby approve of the program and accept the facilities, equipment, supervision and have the opportunity to inspect the premises and equipment and talk to the instructor prior to participation, or waive the right to do so. Further, I understand there are certain risks inherent in participation in all team and individual sports which are beyond the control of the participant or the Town of Blowing Rock’s Recreation Department, and that immediately prior to any participation I have the opportunity to inspect the facility or equipment and notify the instructor or Town of any objection to the facility, equipment, instructor or supervision and have the choice whether or not to participate in said program or activity. I hereby release the Town of Blowing Rock and its employees from all damages on behalf of the instructor or the adequacy of the supervision, facilities or equipment used in the program named above.

Signature of parent or legal guardian ______________________________ Date ____________

Please sign below:

I/We the undersigned parents/guardians of the above named participant acknowledge the Town of Blowing Rock Parks and Recreation does not provide accident insurance for athletic programs as a part of the registration fee for participation. I/We fully understand and agree that the expenses of any accident and/or injury incurred whiled traveling to or from said activity and participating in practices or games shall be at my/our expense, either personally or through any other insurance carrier. Further, I/We do agree to indemnify and hold the Town of Blowing Rock free and harmless from any legal actions or claims.

Parent/Guardian Signature __________________________________ Date _______________

Parent’s Code of Ethics

I hereby pledge to provide positive support, care and encouragement for my child participating in youth sports by following this Parent’s Code of Ethics Pledge.

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

I will place the emotional and physical well being of my child ahead of a 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 in order to encourage a positive and enjoyable experience for all.

I will demand a sports environment for my child that is free of drugs, tobacco and alcohol, and will refrain from their use at all youth sports events.

I will remember that the game is for youth—not for 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 of race, sex, creed or ability.

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

I will require that my child’s coach be trained in the responsibilities of being a youth sports coach and that the coach upholds the Coaches Code of Ethics.

I will read the National Youth Sports Coaches Association Standards for Youth Sports and do what I can to help all youth sports organizations implement and enforce them.

Parent Signature _____________________________________ Date _________________________

Parent Signature _____________________________________ Date _________________________

**If both parents do not sign, it will be assumed they are signing for the entire family.

How did you find out about this program? __newspaper __radio __cable __ school__friend __ other___

Form may be mailed, with payment and birth certificate to: PO Box 47, Blowing Rock, NC 28605

Date rec’d ____ Fee pd. _____ Rec # _____ Birth cert. _____ Staff initial _____