Portland Panther Football and Cheerleading
THIS IS THE NEW REGISTRATION
PACKET. IN IT YOU WILL FIND THE FOLLOWING FORMS:
1 REGISTRATION FORM
1 PARENT OR GUARDIAN CODE OF ETHICS FORM
1 VOLUNTEER / BUY-OUT FORM
1 PLAYER CODE OF ETHICS FORM
1 UNIFORM DISBURSEMENT RECEIPT
1 PHYSICIAN STATEMENT FORM
ALL FORMS MUST BE FILLED OUT AND TURNED IN PRIOR TO THE START OF THE SEASON.
REGISTRATION PRICES ARE AS FOLLOWS:
PLAYER / CHEERLEADER PAYMENT
BEFORE 1 JANUARY 2010
$90 EACH
3 OR MORE $200
PAYMENT FROM
1 JANUARY 2010 TO 1 MAY 2010
$100.00 EACH
3 OR MORE $225.00
PAYMENT
AFTER 1 MAY 2010
$125.00 EACH
3 OR MORE $250.00
NORTHERN CONNECTICUT FOOTBALL LEAGUE
Registration/Parental Consent Form
* Football Player * Cheerleader
NAME: TEAM
BIRTHDATE: A B
YEARS PLAYED:
LEAGUE AGE AS OF AUGUST 1st : C D
ADDRESS:
CITY/TOWN: ZIP:
EMAIL: HOME PHONE:
MOTHER’S NAME: WORK PHONE:
FATHER’S NAME: WORK PHONE:
PERSON TO CONTACT IN CASE OF EMERGENCY
NAME: _________________________________RELATIONSHIP: __________________________
PHONE: (H) ______________________(W)____________________(CELL)_______________________
I authorize the LEAGUE FIRST AIDERS/COACH or EMT to act for me according to their best judgment in an emergency requiring medical attention.
HOSPITAL PREFERENCE: _______________________________________________I/We, the undersigned, parent(s) of the above child hereby consent and give my/our approval to his/her full participation in any and all Northern Connecticut Football League activities. I/We hereby assume all risks and hazards incidental to such participation including transportation to and from such activities. I/We hereby waive, release, absolve and agree to indemnify and hold Northern Connecticut Football League, all its officers, participants, members and any organization, person and/or municipality or other governmental body sponsoring any team in or other activity of the Northern Connecticut Football League harmless from any and all claims by and injury to the above named participant arising out of participation in such activities including transportation to and from such activities.
Signature of Parent/Guardian Date
Below is for League use only
BC_____ MEDICAL_____ REGISTRATION_____ PARENT CODE_____PLAYER CODE_____
ABOVE PLAYER HAS MET ALL REQUMENTS FOR THE _____TEAM AND IS ELIGIBLE TO PLAY
IN THE 20_____SEASON. ___________________________
LEAUGE REP SIGNATURE
PAID CASH_____ CHECK_____CHECK#_____ DATE OF PAYMENT______________
Panther's Football and Cheerleading
Parents’ or Guardians’ Code of Ethics
I hereby pledge to provide positive support, care and encouragement for my child participating in youth sports by following this Code of Ethics:
• I will encourage good sportsmanship by demonstrating positive support for all players, coaches, and officials at every game, practice of other youth sports event.
• I will place the emotional and physical well-being of my child ahead of any personal desire to win.
• I will insist that my child plays in a safe and healthy environment.
• I will provide support for coaches and officials working with my child to provide a positive, enjoyable experience for all.
• I will demand a drug, tobacco and alcohol-free sports environment for my child and agree to assist by refraining from their use at all youth sports events.
• I will remember that the game is for children and 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 will promise to help my child enjoy the youth sports experience within my personal constraints by assisting with coaching, being a respectful fan, providing transportation or whatever I am capable of doing.
• I understand that if I am not a respectful fan that my child’s right to play in the NCFL could be at risk of expulsion for the season and that my towns league could be heavily fined.
Parent or Guardian Signature Date
PANTHER'S FOOTBALL AND CHEERLEADING
PARENTAL VOLUNTEER / BUY-OUT
FOOTBALL/CHEERLEADER NAME __________________________
Child’s Age: ______
Mothers Name _________________________________
Mothers Phone Number - Work _______________ Home _________________
Mothers Email Address ___________________________________________________
Fathers Name __________________________________
Fathers Phone Number - Work ________________ Home _____________
Fathers Email Address _________________________________
PLEASE FILL OUT SECTIONS 1 AND 2. THERE IS A BUY-OUT OPTION FOR BOTH SECTIONS.
SECTION 1: Fundraiser Buyout
This is a key fundraiser for Portland Youth Football and Cheerleading each year. Fundraising helps to keep registration costs low for everyone and pay for equipment for the kids. For each family that does not participate in this fundraiser, another family must pick up the slack. This is not hard work and requires no particular skill. If you were thinking of buying out, please reconsider! Thank you.
_______ I CHOOSE TO VOLUNTEER MY TIME BY HELPING WITH OUR MAJORFUNDRAISOR.
OR
_______ I CHOOSE TO BUY-OUT SECTION 1, AT A COST OF $50.00. AFTER 8/30/08, THIS BUY-OUT FEE WILL INCREASE TO $75.00. This is in addition to registration fees and Section 2 buyout.
SECTION 2: Game Day Buyout
________ I CHOOSE TO VOLUNTEER MY TIME BY CHOOSING TO WORK TWO HOME GAME ACTIVITIES
(Two 2 ½ hour shifts) OR THREE PRACTICES (Three 2 hour shifts)
Snack Shack window (4 people/game)
Snack Shack window (2 people/practices)
Game announcing (1 person/game)
Field Setup / Breakdown (4 pre-game /4 post-game people)
OR
________ I CHOOSE TO BUY-OUT SECTION 2, AT A COST OF $20.00.
This is in addition to registration fees and Section 1 buyout.
Families that fail to support these required activities will be reported to the Executive Board for review and possible withholding of pre-registration package(s) for the following season.
Portland Panther Football and Cheerleading
Players’ Code of Ethics
I hereby pledge to provide a positive attitude and be responsible for my participation in Youth Sports by following this Code of Ethics:
• I will encourage good sportsmanship from fellow players, coaches, officials and parents at every game and practice.
• I will attend every practice and game that is reasonably possible and notify my coach if I cannot.
• I will expect to receive a fair and equal amount of playing time.
• I will do my very best to listen and learn from my coaches.
• I will treat my coaches with respect regardless of race, sex, creed or abilities and I will expect to be treated accordingly.
• I deserve to have fun during my sports experience and will alert parents or coaches if it stops being FUN!
• I deserve to play in an alcohol, tobacco and drug free environment and expect adults to respect that wish.
• I will encourage my parents to be involved with my team in some capacity because it’s important to me.
• I will do my very best in school.
• I will remember that sports are an opportunity to learn and have fun.
Players’ Signature Date
Panther's Football and Cheerleading
Uniform Disbursement Receipt
Name _____________________________________________Team__________ PLEASE PRINT
________Shoulder Pads – Size______ _______Skirt Size_________
________Game Pants – Size________ _______Shell Size_________
__ ________Helmet Size______ _______Warm-up Jacket Size______
________Practice Pants Size_______ _______ Warm-up Pants Size ______
________Practice Shirt Size_______ _______ Body liner Size_______
________Practice Pads Set of 7 ________Pom Pom Set
Game Jersey #________
The Panther Football is issuing these items to your youngster for his or her use during the upcoming season. We will expect the items to be returned at the end of the season in clean condition. We do realize that there will be some wear and tear on the equipment. A basic washing is all that we expect for the returned equipment. For any equipment that is not returned we will require you to be responsible for the replacement costs at the following rates:
Game Jerseys $80.00 Skirt $50.00
Game Pants $50.00 Shell $75.00
Practice Pants $15.00 Jacket $60.00
Practice Shirt $10.00 Body liner $40.00
Shoulder Pads $70.00 Pants $40.00
Helmet $100.00 Pom Pom Set $35.00
Pads $21.00 for 7
I acknowledge the above conditions for the use and return conditions for this uniform equipment.
Signed_____________________________________________Date__________
Parent or Guardian
Signed _____________________________________________Date__________
Panther Equipment Manager
NORTHERN CONNECTICUT FOOTBALL LEAGUE
PHYSICIAN STATEMENT FORM
I have examined or know
First Name Last Name
To be in good health and is able to participate in the normal activities of Youth Football (a contact sport) and/or Cheerleading.
Parent(s) and/or Doctor, please list all known conditions/illnesses/allergies or prior injuries which would/could affect Emergency Medical Treatment.
ILLNESSES ALLERGIES PRIOR INJURIES
CURRENT MEDICATIONS
Physician Name:
Address:
Telephone Number:
Physician/APRN/RN Signature Date _____________
NOTE: THIS STATEMENT MUST BE COMPLETED AND DATED AFTER JANUARY 1 OF THE CURRENT SEASON.
I/We hereby represent that the league medical form is complete, up to date and accurate with my child’s medical history, and that my child has been deemed physically fit to play the contact sport of football or cheerleading by their personal physician (MD), APRN or RN.
Signature of Parent/Guardian ___________________________ Date__________
Panther's Bylaws
Coming Soon - The bylaws will be posted for access.