Congratulations in taking your first steps into

Stanwood Powderpuff Football

Alumni: You're welcome to fill out a new Registration packet, or if not much has changed; see Team Mom to review last year’s registration. Initial/sign with her.

Included in this Registration Packet are the following documents/information:

⃣   Registration 

⃣   Health Information & Emergency Contact Information & Consent

⃣   Waiver of Liability/Hold Harmless Agreement

⃣   Group Discount Aflac Supplemental Medical Insurance- optional

⃣   Volunteer/Player Code of Conduct

⃣   Coaches only:  WA background check Release

⃣   Coach Code of Conduct Guidelines

Please return the above forms signed to your TEAM MOM!

 

OPEN REGISTRATION:  Online thru March 22nd or come to one of our info nights:

 

Feb 19, 2023 at Ixtapa 5 - 7pm

Feb 26, 2023 at Ixtapa 11 - 2pm

March 5, 2023 at Ixtapa 2 – 4pm

 

 

First day of Practice:  Wednesday, March 22nd

PRACTICE DAYS:

  WED 5:00-7pm & SUN 2-4:30pm

2-3 games TBD

Location: TBD in Stanwood.

Stanwood Spartan Powderpuff Registration

Welcome to our team! We're excited to have you! Please fill out the following information.

(No idea? Try: www.rollerderby.namegeneratorfun.com)

What is provided to you...

1. Shoulder pads
2. Helmets
3. Socks 
 

Player responsible for the following:

1. Mouth guard
2. Pants --(with or without pads--optional)
3. Cleats --no metal spikes
4. Paying $100 by March 22.     Sponsor request forms are available, see Team Mom.
 

Players required to sign up for at least 1 event such as:

1. Touch-a-Truck
2. Krispy Kreme Sales
3. Pre-Sale Tickets / Raffle shift of 2 hours or more.

I understand player cost is $100 and includes jersey, regardless if player has uniform from previous year or not, and is to be paid prior to receiving jersey and participating in game(s).  Gear issued is required to be returned cleaned at the end of the year BBQ, or I will be liable for incurred replacement costs, up to $500.

 

I have read the above, given additional forms, and understand football is not without risk.   I can receive a copy of signed documents upon request.  

 

Powderpuff Football: Stanwood Spartan Moms (SSM)

Health Information/Emergency Contact Information Consent

NOTE: To be carried by Team Manager together with team roster for practices, volunteer events, and Game events.

Player / Volunteer Information:

Emergency Contact Information:

In case of emergency, if healthcare provider cannot be reached, I hereby authorize to be treated by certified emergency personnel. (l.e. EMT, First Responder, E.R. Physician

Please call in case of emergency: 

Health Information:

The purpose of the above listed information is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment.

If you have a previous and/or recent injury/surgery within the last year, you need to submit a doctor's note to participate before you're allowed to practice or play in game's. 

If required, please attach Doctor's note.

Consent:

I submit the above information voluntarily, and state to best of my ability the information to be true. I give SSM permission to act in my best interest to provide the necessary steps to aid in emergency care in the absence of emergency contacts. I give medical authorization to emergency contacts to act in my best interest. I have read the waiver herein known as the Powderpuff Football Waiver of Liability/Hold Harmless Agreement, and understand I am releasing any liability towards the releasees described. I understand that SSM will only use the information provided for the sole purpose of an emergency if incapacitated or showing signs of duress. This information will be kept on file with the Team Mom at all times, and is deemed confidential until necessary. I have been given the option to receive a copy via digital or hard copy.

Stanwood Spartan Moms Waiver of Liability/Hold Harmless Agreement

 

1. In consideration for playing or volunteering for Powderpuff Football for the 2018 season,I hereby release, waive, discharge, and covenant not to sue Stanwood Spartan Moms (SSM)or any of the co-sponsoring organizations, its officers, board members, coaches, servants, agents, and employees, or volunteers, (hereinafter referred to as "releases") from any and all liability, claims, demands, actions, and causes of action whatsoever arising out of or relating to any loss, damage, or injury, including death, that may be sustained by me, or to any property belonging to me, whether caused by the releasees, or otherwise, while participating in Powderpuff Football, or while in, on or upon the premises of where the Powderpuff Football is being conducted, while in transit to or from the premises, or in any place or places connected with the Powderpuff Football events.

2. I am fully aware of risks and hazards connected with being on the premises and participating in the Powderpuff Football events, hereby elect to voluntarily participate in the Powderpuff Football events. I voluntarily assume full responsibility for any risk of loss, property damage, or personal injury, including death, that may be sustained by me, or any loss or damage to personal property owned by me, as a result of being a participant in the Powderpuff Football events, whether caused by negligence of releasees or otherwise.

3. I am fully aware that equipment herein described as any additional personal additions to uniform such as headgear (helmet, facemask, and all related components) and pads provided by the Stanwood Spartan Moms (SSM) is provided as extra precautionary safety gear and will not and cannot prevent all potential injury. It is my sole responsibility to inform coaches if the equipment needs adjusting or modification. Due to helmet safety standards, it is important to return all headgear for recertification. I understand that all equipment is given as a loan and is subject to collections if not returned. Any player who does not return equipment will be required topay for replacement of items up to $500* immediately. SSM has the right to sendto collections, issue a lien, or suspend reissuing until paid in full. Players will be given 2 opportunities to return gear in a timely fashion. To learn more about helmet recertification, visit: www.nocsae.org/standards/football/. All headgear will comply with NOCSAE procedures and certification for the safety of all players. *cost pending on size, subject to change without notice. Any player who supplies their own personal headgear must be NOCSAE certified, and logged in the helmet record noting (re)certification number, brand and year. 

4. I hereby acknowledge that upon disclosing any medical or dental concerns being past or present nature, I will not hold SSM accountable for such conditions. In disclosing them on the Health information form, I am proactively communicating health concerns that may help coaching techniques unique to my condition(s I understand SSM is not responsible for providing medical or dental insurance in any capacity. I understand a physical exam within last year has been recommended.

5.Upon requiring medical attention in the scope of prophylactic or emergency care, I hereby acknowledge the caregiver or releases are acting under the Good Samaritan Law (RCW 4.24.300) and shall not be held liable.

6. Any guest accompanying by the player or volunteer in Powderpuff Football shall also be the sole responsibility of the player or volunteer and out of the scope of any due responsibility or liability of SSM.

7. I recognize that possible impacts could cause concussion, and have been informed of related symptoms set forth in addition to this Waiver of Liability/Hold Harmless Agreement hereafter known as the "Release". I waive the right to hold SSM liable for any possible related injuries from any Powderpuff event or being on the premises. I understand any conditions incurred presently or any future conditions that may have resulted from an injury that occurred asa player or volunteer, SSM will not be held liable.

8. I understand any conditions being of personal or bodily injuries that may have lay dormant unrevealing itself until future symptoms or incident arise that may have resulted from injuries sustained thereof, that I will not hold SSM liable for any and all of the following: medical finances, workmen's compensation for loss of time or disability, pain and suffering being of any statute of limitations including but not limited to the following: spousal marital duties, childcare costs shall not be held against any of the releasees. It is my responsibility to see a medical doctor for any possible related symptoms for follow up. in a timely manner.

9. It is my express intent that this Release shall bind the members of my family and spouse, if I am alive, and my heirs, assigns and estate, if I am deceased, and shall be deemed as a release, waiver, discharge, and covenant not to sue the above named releasees. In signing this Release, I acknowledge and represent that:

A. I have read the foregoing Release, understand it, and sign it voluntarily as my own free act and deed.

B. No oral representations, statements or inducements, apart from the foregoing written agreement have been made.

C. I am at least eighteen (18) years of age and fully competent; and

D. I execute this Release for full, adequate and complete consideration fully intending to be bound by the same. I hereby understand that in participating in a Stanwood Spartan Moms sponsored function I will adhere to all rules and regulations, as well as all local, state, and federal laws.

AFLAC! NEW! BENEFIT OPPORTUNITY!

Stanwood Spartan Moms now have access to Aflac coverage that will allow you and your family to have the protection you need most!

How does it work?

Aflac pays cash benefits directly to you, unless otherwise assigned. This means that you will have added financial resources to help with medical costs or ongoing living expenses. Aflac accident plans are designed to provide you with cash benefits throughout the different stages of care, such as the following:

Accidents happen to all kinds of people every day.

Emergency treatment

Hospital admission

Intensive care unit

Ambulance transportation

Travel expenses to distant treatment centers

Everyday living expenses, like your rent or mortgage, utility bills, groceries, and more

 

Why Should You Have This?

We appreciate your time and effort helping your community raising funds to support Stanwood Camano families for kids to play sports. We as an association want to do our part in helping protect and support you, our team. We have reached out and created a benefits offering that provides coverage at reduced rates for you and your families.

What would the financial impact of an injury mean to you? Are you prepared for high medical costs in addition to everyday household expenditures and lost wages? Out- of-pocket expenses associated with an accident are unexpected, but an accident's impact on your finances and your well-being certainly can be reduced. Aflac is here to help. If you have an accident, major medical insurance will help with many medical expenses, but you could be left with out-of-pocket expenses. You could also lose pay while you're out of work. And you can be sure that the bills will keep coming.

When I can sign up?

Registration is open now for alumni powderpuff player or immediate family members. It is best to sign up right away so you and your family can be covered as soon as possible. Have an existing injury? Our dedicated Aflac advisor is available year round to help answer any questions or concerns that you might have.

How much does it cost?

Plans vary depending on desired coverage and whether you wish to cover your family or just yourself. Pricing ranges from $5-$15 per week. See our dedicated Aflac advisor for more details.

Anya Paxson Certified Benefits Councilor

Aflac Pacific North West District

1932 E College Way, Mount Vernon WA 98273

Direct: 360.610.5665

Anya_Paxson@us.aflac.com

Stanwood Spartan Moms Volunteer/Player Guidelines

Code of Conduct & Rules

Using, possessing or being under the influence of alcohol or illegal drugs will not be tolerated and is strictly prohibited.

Volunteers/Players must keep the health and safety of other players as the main focus during practice sessions and games.

Volunteers/Players must use positive techniques of guidance, including positive reinforcement and encouragement.

Volunteers/Players will demonstrate how to win graciously and lose without complaining or criticizing the officials, other players or coaches.

Volunteers/Players will refrain from posting on social media any negative comments or negative photos of any coaches, teammates, other opposing team players, board members or officials.

Volunteers/Players will return all gear at the end of the season

Volunteers/Players understand that any violation of the Code of Conduct & Rules may be cause for removal from the Stanwood Spartan Moms.

 

 

Participation and Release from Liability

Volunteer Terms: I understand Stanwood Spartan Moms does not provide insurance plans for volunteers, including no medical, accident, dental, workers compensation, disability, or other coverage.

Property Loss: I understand Stanwood Spartan Moms is not responsible for my personal property lost, damaged or stolen while participating in Stanwood Spartan Moms volunteer activities

Photograph Permission: I give permission for Stanwood Spartan Moms to use without limitation or obligation, photographs or other media that may include my image to promote and advertise for Stanwood Spartan Moms.

 

I have read and being fully aware of the matters in this document and would like to volunteer/play for the Stanwood Spartan Moms.

Coaches/Volunteer Guidelines

 

Using, possessing or being under the influence of alcohol or illegal drugs will not be tolerated and is strictly prohibited.

The Coaches must keep the health and safety of other players as the main focus during practice sessions and games.

The Coaches must use positive techniques of guidance. including positive reinforcement and encouragement.

The Coaches will demonstrate how to win graciously and lose without complaining or criticizing the officials, other players or coaches.

The Coaches will refrain from posting on social media any negative comments or negative photos of any coaches, teammates, other opposing team players, board members or officials.

The Head Coach will return all gear at the end of the season Coaches shall be approved on a yearly basis by the board.

The Coaches shall get unanimous approval from the board prior to any purchases including reimbursements.

The Coaches understand that any violation of the Code of Conduct & Rules may be cause for removal from the Stanwood Spartan Moms.

The Coaches will be given WA background check. The Coaches will be given information on concussions according to CDC.

 

Participation and Release from Liability

Volunteer Terms: I understand Stanwood Spartan Moms does not provide insurance plans for volunteers, including no medical, accident, dental, workers compensation, disability, or other coverage.

Property Loss: I understand Stanwood Spartan Moms is not responsible for my personal property lost, damaged or stolen while participating in Stanwood Spartan Moms volunteer activities

Photograph Permission: I give permission for Stanwood Spartan Moms to use without limitation or obligation, photographs or other media that may include my image to promote and advertise for Stanwood Spartan Moms.

I have read and being fully aware of the matters in this document and would like to Coach/Volunteer for the Stanwood Spartan Moms.