Registration Wizard

Complete Registration Form

2017 Bartlesville YMCA Football Registration

FOOTBALL PLAYER INFORMATION

mm/dd/yyyy
  • YES
  • NO
Did you play in the INFC last year?
  • YES
  • NO
If you select NO, you are telling us your player requests to back into the draft.
If you do not have insurance on your player, type NONE in the box above.

PARENT 1 - INFORMATION

xxx-xxx-xxxx
xxx-xxx-xxxx
xxx-xxx-xxxx
This information is used for text messaging capabilities.

PARENT 2 - INFORMATION

xxx-xxx-xxxx
xxx-xxx-xxxx
xxx-xxx-xxxx
This information is used for text messaging capabilities.

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Waivers

INDIAN NATIONS YOUTH SPORTS - TERMS & CONDITIONS:

By checking the box below, I the registrant and/or legal guardian of the registrant am legally agreeing to all terms and conditions set forth by Indian Nations Youth Sports and the individual club and/or organization in which I am registering.

I am agreeing that I am at least 18 years of age and the legal guardian of the person/persons registering hereof. I further agree that any information provided in the following pages is truthful and accurate to the best of my knowledge.

I also state that any falsification of documents, illicit or immoral activities will be punished pursuant to the by-laws of the proper governing authorities, and that such activity will lead to penalties including: no reimbursement of funds and partial or permanent expulsion from the affiliation/organization I am applying for.

Right to Refuse Service

By accepting the terms of membership in the Indian Nations Youth Sports (INYS) programs I acknowledge that the INYS is a private organization and that it reserves the right to refuse membership and/or participation to any person whose actions hinder the activities of the INYS and that such determination will be at the sole discretion of Indian Nations Youth Sports.

Arbitration

IT IS AGREED THAT ANY MATTER IN DISPUTE BETWEEN YOU AND INDIAN NATIONS YOUTH SPORTS SHALL BE SUBJECT TO ARBITRATION AS AN ALTERNATIVE TO COURT ACTION PURSUANT TO THE RULES OF THE AMERICAN ARBITRATION ASSOCIATION, A COPY OF WHICH IS AVAILABLE ON REQUEST FROM THE COMPANY. ANY DECISION REACHED BY ARBITRATION SHALL BE BINDING UPON BOTH YOU AND THE COMPANY. THE ARBITRATION AWARD MAY INCLUDE ATTORNEY'S FEES IF ALLOWED BY STATE LAW AND MAY BE ENTERED AS A JUDGEMENT IN ANY COURT OF PROPER JURISDICTION.

Attorney's fees

The Parties agree that if Indian Nations Youth Sports prevails in any litigation or arbitration brought arising from any dispute, then INYS shall be entitled to recover all costs, expenses and attorney’s fees associated therewith.

PARTICIPATION AUTHORIZATION AND RELEASE OF LIABILITY:

For himself/herself and for his/her spouse and for his/her child and other children hereby represents and agrees to the following:
My child has my permission to participate in all sponsored or endorsed activities. The Association and its Board Members and Directors, Officers, Coaches, Coaching Staffs, agents and licensees are hereby released from any and all liability or responsibility for any injury that may occur to my child, to me, to my spouse and any of my other children resulting directly or indirectly from my child's participation in activities including, but not necessarily limited to, league tournaments, practice games, practices, transportation to and from games and tournaments or otherwise and the use of practice facilities, games facilities, concession facilities or any other facility.

AUTHORIZATION FOR EMERGENCY TREATMENT

In the event of a medical emergency, I hereby authorize my child to be transported to the nearest emergency room or medical facility. I also authorize officials to secure the use of an ambulance for transporting my child to the hospital and/or to administer first aid treatment as necessary. I further authorize any physician, surgeon or dentist of the nearest emergency medical center to administer any emergency treatment procedure or medicine necessary or advisable, when accompanied by an adult. I further agree to pay the hospital, doctors and ambulance fees for all services rendered to the above named child. I request that this authorization remain in force from this date until the end of the calendar year unless notified in writing of a change by me.

RULES AND REGULATIONS CONTRACT:

I have read the Rules and Regulations and Code of Ethics, of which I have a copy, as stated by the Board of Directors. I hereby agree to abide by said rules and regulations. I have also read and fully understand the penalties prescribed for violation or non-compliance of said rules and regulations and by checking the box do agree to these terms and conditions.

YMCA, Liability Release, Photo Video Release, Code of Conduct

Liability And Medical Release
In the event that my child is taken to the Emergency room or Medical Care facility and need of treatment in my absence from attendance, I hereby give consent to authorize treatment for this child by the Doctor(s) they deem necessary.
I further knowledge that my child’s participation in football program is with complete knowledge of the risk involved and hereby agree to assume those risks and to hold the Richard Kane YMCA, all of its officers, employees, coaches or elected offices free from liability of any nature whatsoever for any injury, harm, or complication that may result, directly, by reason of my child’s participation in this program.
I acknowledge that this athletic event is an extreme test of a person’s physical and mental limits and carries with it the potential for death, serious injury and property loss. The risk includes, but are not limited to: actions of the people including, but not limited to, participants, volunteers, spectators, coaches, event officials, event, monitors and/or producers of the event; lack of hydration, weather, and/or other natural condition. I hereby assume all of the risks of participating in this event.
I certify that I am physically fit, have sufficient trained for participation in this event and have not been advised otherwise by a qualified medical person.
I acknowledge that this Accident Waiver and Release of Liability (AWRL) form will be used by Richard Kane YMCA and the sponsors of the event in which I may participate and it will govern my actions and responsibilities at aid event.
In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assign as follows: (A) Waive, release, and discharge from any and all liability for my death, disability, personal injury, property damage, property theft or action of any kind which may hereafter accurate to me or my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: Richard Kane YMCA and their directors, officers, employees, volunteers, representatives, and agents, the event sponsors and the events volunteers, (B) identify and hold harmless all entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of my actions during this event.
I hereby consent to receive medical treatment that may be deemed advisable in the event of injurie, accident, and/or illness during this event.
This AWRL shall be construed broadly to provide a release and waiver to the maximum extent permissible under the applicable law.

PHOTO AND VIDEO/AUDIO RECORDING RELEASE
I am 18 years of age or older and, if not, my Mother/Father/Legal Guardian has also signed below.
For my participation in activities to be conducted by the National Council of young Men’s Christian Associations of the United Stated of America (YMCA of the USA), hereby give my permission and consent, now and for all time, to YMCA of the USA and collaborating third parts to make, reproduce, edit, broadcast or rebroadcast any video film, footage, sound track recording or photo reproductions of me and/or my narrative account of my experience within said activities, for publication, display, sale or exhibition thereof in promotion, advertising, education and legitimate business uses without any compensations to, and/or claim, by me. I may, or may not be, identify in such reproductions; however, I shall not be stated by name to have endorsed any particular commercial products or commercial services.
I further agree to the following:
Any video film, footage, sound track recording, and photo reproductions of me and/or my narrative account of my experience during said activities, I authorize, according to the Release, shall belong to YMCA of the USA and collaborating with third parties. Therefore, they will have full right of disposition of any video film, footage, sound track record and photo reproduction of me and/or my narrative account of my experience within said activities;
Any video film, footage, sound track recording, and photo reproductions of me and/or my narrative account of my experience during said activities will not be subjected to any obligation of confidentiality and may be shared with and used by YMCA of the USA and collaborating third parts;
YMCA of the USA and collaborating third parties collaborating shall not be shall not be liable for any use or disclosure to a third part of any video film, footage, sound track recording, and photo reproductions of me and/or my narrative account of my experience’ and
YMCA of the USA and collaborating third parties shall exclusively own all known or later existing worldwide and shall be entitled to the unrestricted use of any video film, footage, sound track recordings, and photo reproductions of me and/or my narrative account of my experience for any purpose without compensation to me.
I agree that my consent and this release are irrevocable. I hereby release and discharge YMCA of the USA and collaborating third parties from any and all claims in connection with the uses and reproductions, any video film, footage, sound track recording and photo reproductions of me and/or my narrative account of my experiences as described herein.

Code of Conduct
The essential elements of character building and ethic in athletics are embodied in the concept of sportsmanship and the YMCA four core Values of Honesty, Caring, Respect and Responsibility.
All parents who participate in the Richard Kane YMCA Athletic Programs:
Will refrain from coaching their child or other players during games and practices
Will respect the officials and their authority during games and we will never question, discuss or confront coaches at game field, and will make time to speak to coaches in agree up on time and place.
Will remember that athletes participate to have fun and that game is for youth and not adults.
Will help teach their teach their child that doing one’s best is more important than winning, so that my child will never feel defeated by the outcome of the game or his or her performance.
Will demand that their child treat other players, coaches, officials, and spectators with respect regardless or race, creed, color, sex or ability.
Will promote the emotional and physical well being of the athletes ahead of any personal desire I may have for my own child to win.
Will not encourage any behaviors or practices that would endanger the health and wellbeing of the student athletes.
Will be a positive role model for ethical child and encourage sportsmanship by showing respect and courtesy, and by demonstrating positive support for all players, coaches, officials, and spectators at every game, practice or sport event.
Will not engage in any kind of unsportsmanlike conduct with any official, coach, player, or parent such as booing and taunting; refusing to shake hands; or using profane language or gestures.
Parents or guests in violation of the code of conduct may be dismissed, suspended, or permanently expelled from future athletic contest.
The Richard Kane YMCA will take the appropriate steps listed below if administrative consequences are necessary. (One or more of the violations may be applied).
Verbal warning issued by the League, Organization or YMCA Official.
Written warning issued by the League, Organization or YMCA Official.
Suspension or immediate ejection from a youth sports event issued by a League, Organization or YMCA Official. Officials who is authorized to issue such suspension or ejection by YMCA board or youth sports organization.
Suspension from multiple youth sports events issued by a League, Organization or YMCA Official who is authorized to issue such suspension issue suck suspension.
Season suspension or multiple season suspension issued by a YMCA Official.

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