Registration Form. This form must be filled out in its entirety. When submitting this form you need to also email a copy of the child’s physical to cyaacolts@gmail.com. A physical is due once a year for all sports.
Registration/Consent & Release Form
(Click Green Words Above for Form)
By submitting the form above you are acknowledging that you have read and agree to the following :
–I understand that no refund will be given after the first day of practice regardless if the student attends the first practice or not.
–I also understand that any uniform or other cost incurred by the CYAA will be deducted from any entitled refund.
–I understand that I will be responsible for reimbursing the Cloverleaf Youth Athletic Association, Inc. (CYAA) for any returned checks including a $25 service charge for all returned checks and that my child will not be allowed to play another sport through the association until all sign-up fees and service charges are paid in full.
–I understand that issued uniforms and equipment are the sole property of CYAA.
–I understand that I am required and solely responsible for the care of the uniform and equipment and am responsible for returning the uniform and equipment in the condition in which it was issued to the participant’s coach. Failure to comply with this rule will result in the following consequences:
• Withholding any award for trophy due to the participant
• Withholding the right for that participant to sign up for any other sport
• Bill to participant’s parent/legal guardian the replacement cost of uniform or equipment not returned
–As a parent/legal guardian of a child participating in a CYAA sports program, I am expected to accept responsibility on a limited basis to operate concession stands and admission gates for any related athletic programs in which my child participates. This service is on a volunteer basis: however, your participation and support are encouraged, but most importantly needed in order to continue the success of this program.
–I affirm that to the best of my knowledge the below named child is physically capable of participating in the sport or activity named above.
–I further understand that the responsibility for identifying medical needs of my child is mine and not CYAA, its coaches, officials or representatives.
–Furthermore, in consideration of the training in athletics and sportsmanship being provided to put the child in connection with such practicing, playing and participation in the athletic program involved and recognizing that by participating in such activities, there is inherent risk and chance of injury, the undersigned parent or guardian responsible for his/her care herby releases the coaches, officials, the CYAA and any other person constituting a part of any team or program in any capacity whatsoever from any liability because of injury for loss as a result of or incident to my child’s involvement.
–I, the undersigned parent or guardian of the abovenamed participant in the youth activity sponsored by the CYAA, hereby gives my consent to his/her practicing, playing and otherwise participating in said related activity.
Acknowledgement of Concussion Information For Parents/Players
You will be getting a hard copy of this form at the first parent meeting to sign. This has to be signed before your child can participate.
Statement
I acknowledge that there is a risk of injury involved with athletic participation. Even with appropriate coaching,
use of protective equipment, and observance of the rules, injuries are a possibility, and in rare occasions can
be severe enough to result in disability, paralysis, or even death. Included in these injuries could be a
concussion, which is a type of traumatic brain injury (TBI) that changes the way the brain normally works. A
concussion is caused by a bump, blow, or jolt to the head or body that causes the head and brain to move
quickly back and forth. Even what seems to be a mild bump or blow to the head can be serious.
Resources
The Centers for Disease Control (CDC) has developed a series of educational materials, the HEADS UP
program, with the goal to help protect children and teens from concussions and other serious brain injuries.
This information is also applicable to adult sports, but specifically emphasizes youth programs since youth are
more likely to get concussions and can take longer to recover. ICPRD sports programs utilizes these resources
in order to educate those involved with our programs. Education should include, but not be limited to, the
definition and causes of concussions, signs and symptoms of concussions, and procedures for
treatment/return to play. Information sheets and the website resources are available for parents. Information
sheets will be provided during registration, or prior to participation by the player in practices or games.
Signing the hard copy of this form indicates that you read the Acknowledgement of Concussion Information For Parents/Players on the CYAA Website and agree:
–I am aware of the risk of concussion or other injuries from my (or my child’s) participation in ICPRD programs or events. Participation in these programs are completely voluntary.
— I have been provided with a “Concussion Fact Sheet” (either a hard copy or via a website link) and have mread and understand the information. I am aware of signs/symptoms and guidelines for treatment.
— In the event of a suspected concussion, I agree to follow the concussion guidelines, including removal of the player from the activity for at least 24 hours, medical evaluation following the injury by a health care professional that is qualified to evaluate concussions, and if diagnosed with a concussion, will provide any necessary medical care and follow any return-to-play guidelines provided. The player should only return to play with written permission from a health care professional, and a copy will be provided to the team coach/manager prior to return-to-play.
NORTH IREDELL YOUTH ATHLETIC ASSOCAITION CODE OF CONDUCT
You will be getting a hard copy of this form at the first parent meeting to sign. This has to be signed before your child can participate.
- I will remember that children participate to have fun and that the game is for youth and not ADULTS.
- I will inform the coach of any physical disabilities or ailments that may affect the safety of my child or other players.
- I will learn the rules of the game and the policies of the league.
- I (and my guests) will be a positive role model for my children and encourage good sportsmanship by showing respect and
courtesy and by demonstrating positive support for all players, coaches, officials, and spectators at every game, practice, or event. - I will teach my child to play by the rules and to resolve conflicts without resorting to hostility or violence.
- I will demand that my child treat other players fairly and make all players feel like a “winner” every time.
- I (and my guests) will never ridicule or yell at my child or other participants for making a mistake or losing a game.
- I will respect the officials and their authority during games.
- I will never question, discuss, or confront coaches at an event, game or practice. I will take time to speak with coaches at an
agreed upon time and place (see 24-Hour Policy). - Unless I am an official coach, I will refrain from coaching my child or other players during practices and games.
- I will refrain from using drugs, alcohol, and tobacco at any sporting event, including practices or meetings.
NIYAA CONFLICT OF INTREST POLICY (24-Hour Policy)
Due to prior incidents from previous activities in the past, we have instituted the following guidelines on how we approach coaches or
any representative from any of the organizations involved with the NIYAA. - In the act of any disagreement between a player or coach, or coach and parent, or anyone and an organization involved, there will
be a mandatory 24-hour cool down period. - If there is a conflict which requires a 24-hour cool down period, those individuals must contact each other by phone or email only
and only after the 24-hour period. - If there cannot be an agreement settled by phone or email and requires a face-to-face discussion, then the director over the sport
for the school in which it involves must be present. - If involves two separate schools, directors from both schools must be present. If there cannot be an agreement settled with the
schools and/or directors involved, then it must be settled with the NIYAA board. - If any individual approaches a coach or organizational member during or following a NIYAA scheduled event prior to 24-
hours, it will result in an automatic one-week suspension from any NIYAA events. If the same individual repeats this
infraction during the same season, an automatic one-year suspension will be enforced with the possibility of a lifetime
ban from any NIYAA functions or events.
NIYAA DISCIPLINARY ACTION POLICY
All participants and adult stakeholders are expected to be responsible for their words and actions while attending, coaching or
participating in any way in a youth sport event hosted by the North Iredell Youth Athletic Association (NIYAA) and they shall conform
their behavior to the leagues CODE OF CONDUCT AND NIYAA CONFLICT OF INTEREST (24 Hour Policy). Failure to adhere to
these policies can and will result in disciplinary action determined by the NIYAA. The disciplinary actions can include, but are not
limited to, the following in any order or combination: - Verbal warning by the league, official or law enforcement.
- Written warning by league, official or law enforcement.
- Suspension or immediate ejection from a youth sports event issued by the league, organization official or law enforcement
who is authorized to issue a suspension or ejection by the NIYAA or school representative. - Suspension from multiple youth sports event issued by the league, organization official or law enforcement.
- Season and/or multiple season suspension issued by the league, organization official or law enforcement.
I have read CODE OF CONDUCT, CONFLICT OF INTEREST (24HR POLICY) AND DISCIPLINARY ACTION POLICIES.
By signing the hard copy of this form I acknowledge that
1) I received a copy of these policies and
2) I have read through and understand these policies. I agree to comply with these expectations, and in the event that I or my affiliates may fail to do so, I am fully aware of the disciplinary action the NIYAA may impose on the offender(s).