The Mission of The Northside Pirates Football Club and Cheerleading. is to organize and maintain recreational youth football and cheerleading for the children of Spokane and surrounding areas in an instructional nature; to provide adequate supervision and guidance; to promote the development of honesty, good fellowship, self-discipline, and team play, which are the basic essentials of Good Sportsmanship. Attached are the required forms for participation in this program. They must be completed prior to receiving your child’s uniform and equipment.

 Player’s Code of Conduct (Review with your child and have your child sign the form).  Parent’s Code of Conduct (Parents review this form and sign).  Amateur Minor Athletic Waiver and Release of Liability (Completed by

 Medical Treatment Consent Form (Completed by Parent/Guardian).
Also, we will need

 Current Physical (must be completed after 4/15/09).  Copy of your child’s birth certificate.

A current physical is mandatory prior to the first day of practice. Your child will not be allowed to participate until Muth Youth has received a current physical.

PARENT MEETING - TBD July 29, 2009 Equipment Hand-Out Location Fischer Hall - 613 S. Main Street - Frankenmuth Time – 6pm – 7:30 pm August 17, 2009 First day of Practice – CURRENT PHYSICAL IS DUE! Football Players – Wear Cleats, helmet, shorts and T-Shirt. Cheerleaders – Wear comfortable clothing September 8, 2009 Game Schedule is released. Your child’s coach will provide schedule. October 28, 2009 Equipment Turn-In Location - Fischer Hall - 613 S. Main Street - Frankenmuth Time – 6pm – 7:30 pm November 1, 2009 End of Season Banquet

Location TBD Time : TBD

I hereby pledge to provide a positive attitude and be responsible for my participation in The Northside Pirates Football Club and Cheerleading by following this Code of Conduct: 1. I will do my very best in school. 2. I will encourage good sportsmanship from players, coaches, cheerleaders, officials and parents at every game and practice. 3. I will attend every practice and game that is reasonably possible and notify my coach if I cannot. 4. 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 will expect to be treated accordingly. 5. I will give 100% effort to learn the game of football or cheerleading. 6. I will do my best to fairly help my team and teammates achieve our goals. 7. I will be honest, self-disciplined and treat my teammates and opposing players/cheerleaders with respect. 8. I will never use obscene language or gestures. 9. I will never be physically or verbally intimidating to other players/cheerleaders. 10. I deserve to have fund during my sports experience and will alert my parents or coaches if it stops being fun. 11. I will encourage my parents to be involved with my team in some capacity because it’s important to me. 12. I will remember that sports are an opportunity to learn, make friends and have fun. I acknowledge that I have read The Northside Pirates Football Club and Cheerleading Code of Conduct and will adhere to it. I understand that violating the Player’s Code of Conduct may result in the suspension or termination of my participation in The Northside Pirates Football Club and Cheerleading program.

Player or Cheerleader Signature Date

I hereby pledge to provide positive support, care and encouragement for my child while participating in The Northside Pirates Football Club and Cheerleading by following this code of conduct. 1. I will encourage good sportsmanship by demonstrating positive support for all players, coaches and officials at every game, practice or other youth sports event. 2. I understand in order to make Northside Youth successful, it is expected that I will volunteer during all home games, which may include, chain gang, set-up, clean-up. 3. I will place the emotional and physical well being of my child ahead of any personal drive to win. 4. I will insist that my child plays in a safe and healthy environment. 5. I will provide support for all coaches and officials working with my child to provide a positive enjoyable experience for all. 6. I will emphasize the benefit of skill development and practices and how this will benefit my child’s game. 7. I will stress the importance of practice over the short-term excitement of games. (Winning probably means more to you than it does your child.) 8. I will applaud good effort in victory and defeat and emphasize the positive points of the game. 9. I will remember that the game is for the players and not the adults. 10. I will do my very best to make youth sports fun for my child. 11. I will ask my child to treat other players, coaches, fans and officials with respect regardless of race, sex, creed or ability. 12. I will welcome visiting teams and treat them as I would like to be treated. 13. I will not criticize players and will never lose sight of the fact that I am a role model. I understand that children imitate their role models and by acting appropriately, I will be modeling what I expect of my child. 14. I will never embarrass my child or The Northside Pirates Football Club and Cheerleading program by verbally abusing or insulting players, coaches, other parents or officials. 15. If something occurs which I disagree, I will calmly seek an appropriate solution, at the appropriate time. I understand that instigating or participating in a confrontation in front of any children will not be allowed. 16. I will show a positive attitude towards the game all of its participants. A positive approach will benefit me and all children participating. 17. I understand and will support The Northside Pirates Football Club Mission. I/We ______________________________ the Parent(s)/Guardian(s) of ________________________

Acknowledge that I/We have read The Northside Pirates Football Club Parent Code of Conduct and will adhere to it. I understand that violating the Parent Code of Conduct may result in the suspension or termination of my child’s participation in the Frankenmuth Youth Football and Cheerleading program. Parent/Guardian Signature(s) Date

In consideration of being allowed to participate in any way in Frankenmuth Youth Football and Cheerleading and Mid-Michigan Rural Football League (MMRFL) athletics/sports program and related events and activities, the undersigned. 1. Agree that the parent(s) and/or legal guardian(s) will instruct the minor participant that prior to participating he or she should inspect the facilities and equipment to be used and if the participant believes anything is unsafe, he or she should immediately advise his or her coach or supervisor of such condition(s) and refuse to participate. 2. Acknowledge and fully understand that each participant will be engaging in activities that involve risk of serious injury, including permanent disability and death, and severe social and economic losses which might result not only from their own actions, inactions, or negligence but the action, inaction, and negligence of others, or the condition of the premises or of any equipment used. Further, that there may be other risks not known to us or not reasonably foreseeable at this time. 3. Assume all the foregoing risks and accepts personal responsibility for the damages following such injury, permanent total disability or death. 4. Release, waive, discharge and covenant not to sue Frankenmuth Youth Football and Cheerleading Inc./MMRFL it affiliated clubs, their respective administrators, directors, agents, and other employees of the organization, other members/participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors or premises used to conduct the event, all of which are hereinafter referred to as “releases” from any and all liability to each of the undersigned, his or her heirs and next of kin for any and all claims, demands, losses or damages on account of injury, including death and damage to property, caused or alleged to be caused in whole or in part by the negligence of the releases or otherwise. I HAVE READ THE ABOVE WAIVER AND RELEASE, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT AND SIGN IT VOLUNTARILY.

Participant/Child’s Name (one per waiver) _______________________________________________ Participant/Child’s Address __________________________________ City _____________________ Name of Parent/Guardian _____________________________________________________________ Relationship to Participant/Child _______________________________________________________ Phone Number (s) of Parent/Guardian ( ___________ ) _______ - ___________ ( ) _______ -

Signature of Parent/Guardian __________________________________________ Date ___________ Participant is: Cheerleader Football Player

Print Name of Participant/Child ____________________________________ Date of Birth ________
I (the undersigned), as the Parent or Legal Guardian of the child shown above, understand that as a result of his/her athletic participation, an injury could occur that may require medical attention. I further acknowledge that on occasion the coaches and staff of Mid-Michigan Rural Football League (MMRFL), Local Area Staff, and available medical personnel may be unable to contact me immediately for my consent for emergency medical care. I do hereby authorize the staff of the Frankenmuth Youth Football and Cheerleading Inc. to consent on my behalf as they may deem necessary to such emergency medical care, including ambulance transport and hospital care, as may be deemed necessary under the then existing circumstances by available medical personnel. In so doing, I assume responsibility for the expenses of any such care not covered by my insurance.

__________________________________________________________________ _______________ Signature of Parent or Legal Guardian Date __________________________________________________________________ _______________ Medical Insurance Carrier Group # __________________________________________________________________ _______________

Name of Insured Member # 1. Please list any health problems that might be significant to a physician evaluating your child in an emergency. _______________________________________________________________________ ________ _______________________________________________________________________ ________ 2. Please list any allergies to medications, etc. _______________________________________________________________________ ________ _______________________________________________________________________ ________ 3. Has the participant/child been prescribed an inhaler or epipen? YES NO 4. Is the participant/child currently taking any medication? YES NO If yes, list type and dose of medication. ___________________________________________________________________ EMERGENCY AUTHORIZATION – In the event that I cannot be reached in an emergency, I hereby give permission to the physicians selected by the coaches to hospitalize, secure proper treatment for and to order injection and/or anesthesia and/or surgery for the participant/child named above. I certify that all information is correct. Daytime Phone _________________________Evening Phone _______________________________ Cell Phone ____________________________ Email Address ________________________________ _______________________________________________________________ __________________ Signature of Parent or Legal Guardian Date
*Emergency Permission Form may be reproduced to travel with the respective teams and is acceptable for emergency treatment, if needed.

Sign up to vote on this title
UsefulNot useful