Apollo-Ridge Youth Basketball Registration Form 2024-2025 In-House 3rd-6th

APOLLO-RIDGE VIKING ELEMENTARY BASKETBALL

The Apollo-Ridge Vikings Boys and Girls Elementary Basketball program is designed to teach all players in grades 2-6 the fundamentals and skills of basketball. The third to sixth grade program is designed to allow players to develop skills in practice and provide experience playing in games. Teams will be coed and combine grade levels for 3rd & 4th grade. It is our intention if registration numbers permit to have combine grade levels for 5th & 6th grades, but separate brackets for each gender. Each player will receive a game shirt. *Travel team registration will be held at a later date. There will be one team per grade per gender, so tryouts will be required. An additional registration fee will be required for any student that makes the travel team.

Goals:

To learn the fundamentals and rules of basketball.
To gain experience playing the game of basketball.
to develop team skills and encourage sportsmanship.
To raise awareness and participation of basketball in the Apollo-Ridge School District.

*Cost: $75 per player: Each player will receive tickets to sell that will reimburse $50 to the family once sold. (cash or money order only made out to AR Viking Elementary Basketball)

**NEW** You may now pay with paypal! When choosing this option, you will be instructed to pay through PayPal upon submission. There is a 4% fee with this option that will be automatically added to your total owed.

*Complete entire form and code of conduct and mail payment to: P.O. Box 343, Apollo, PA 15613 (do not return form and/or payment to the school)

*Practice/Game schedule will be announced pending gym availability.
*Send any questions to arelembasketball@gmail.com

*Registration Deadline is Monday, September 11, 2025. No late registrations will be accepted to allow for splitting up teams and ordering shirts. All fees are due at the time of registration.

3rd4th5th6th

Athlete Information

Player Name*

First NameLast Name

MaleFemale

Shirt Size (Youth small - Adult 2XLarge) *

Jersey number preference (Number not guaranteed but we will do our best)*

YesNo

Parent/Guardian Name*

First NameLast Name

Parent/Guardian Phone#*

Area CodePhone Number

Parent/Guardian Email*

example@example.com

Parent/Guardian 2 Name

First NameLast Name

Parent/Guardian 2 Phone#

Area CodePhone Number

Parent/Guardian 2 Email

example@example.com

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Head CoachAssistant Coach

My Products

PayPal$78.00

You will be invoiced through email.

Money order$ Free

$75 Payment or $25 Payment for each additional child in the same household paid by money order to be mailed to the P.O box

Additional Child - Paypal$26.00

Choose this option if you have already registered one child. This is only for additional Children in the same household.

Total $0.00

Please indicate if you have either of the following and your relationship to the child: CPR Certification and/or Child Abuse/Criminal Background Clearances

Emergency Contact & Health Insurance Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

YesNo, I'll pay with cash.

Name of Policy Holder

Insurance Carrier

Subscriber ID/Group Number

YesNo

Please describe

Parental Permission For Emergency Treatment In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to: I give consent for the facility to secure any and all necessary emergency medical care for my child.

Name of Physician / Emergency Medical Care Facility

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Area CodePhone Number

Release of Liability

I, the parent/guardian of the above named participant, hereby give my permission for my child to participate in any Apollo-Ridge Viking Youth Basketball activities. I am aware that participation in basketball may result in serious injuries and protective equipment does not prevent all injuries to the player, and do hereby, release, absolve, and agree to hold harmless Apollo-Ridge School District, Apollo-Ridge Viking Youth Basketball, its organizers, sponsors, other participants and coaches for any claim arising out of an injury to my child.

I will conduct myself in a manner that will enhance the positive aspect of this basketball experience for my child.

YesNo

Confirmation E-mail*

Signature*

Apollo-Ridge Elementary Basketball League

CODE OF CONDUCT

I. PHILOSOPHY AND PURPOSE:

A. The A-R Viking Elementary Basketball League recognizes the positive effect of participation in extracurricular activities; however, the need exists to state a uniform code of conduct for extracurricular activities.

B. The purpose of this code is to assist players, coaches and parents in making positive decisions when participating and/or attending a A-R Viking Elementary Basketball League contest.

C. It is a privilege to participate in and/or attend an elementary basketball game. Spectators, players and coaches are expected to exhibit pride in self and school. They are expected to exemplify standards consistent with good citizenship as well as good sportsmanship.

D. Please read these rules and guidelines carefully. Your signature on the form titled “Acknowledgement of Apollo-Ridge Viking Elementary Basketball League Code of Conduct” indicates you, and any guests who attend the contest with you, understand the guidelines and will abide by them.

II. RULES: Each player, coach and/or parent must comply with the following rules:

A. Each player must have a signed “Code of Conduct'' form on file before participating in any contest.

B. Each player, coach and/or spectator will conduct themselves as ladies or gentlemen at all times.

C. All players must regularly attend all practices unless excused by the coach.

D. All players must meet normal school requirements in regards to school behavior and academic expectations.

E. THE FOLLOWING TYPES OF BEHAVIOR WILL NOT BE TOLERATED:

1. Yelling at referees, coaches, players, game workers or spectators in a degrading or disrespectful manner.

2. Throwing any objects on the floor.

3. Entering the playing floor at any time before, during or after any contest unless instructed to do so by league officials.

4. Conduct that in any way will disrupt the continuation of any contest.

III. PENALTIES FOR VIOLATION: Violations of any of the aforementioned rules may result in any or all of the following consequences:

A. Verbal warning by official, head coach or board member of the league.

B. Requested removal from contest and gymnasium.

C. One game suspension from participating in or attending an elementary contest with written documentation of the incident to be kept on file with the league.

D. Multiple games suspension from participating in or attending any elementary contests.

E. Removal of player from team and/or total ban from attending any elementary contests for player and/or spectator.

F. Game forfeit.

IV. RULE ENFORCEMENT:

A. Parent Board Representatives have final approval over any consequences.

ACKNOWLEDGMENT OF “CODE OF CONDUCT” PLAYER:

I acknowledge that I have received a copy of and read the Apollo-Ridge Viking Elementary Basketball League “Code of Conduct” for participants and parents. I understand the Code and realize that I am subject to disciplinary measures should I or my parents violate the code. I do agree to conduct myself in accordance with the rules of the “Code of Conduct” and with any other specific rules of my coach.

Signature

Read above Code of Conduct:

PARENT OR GUARDIAN: As the parent and/or guardian of the above student, I have read the Apollo-Ridge Viking Elementary Basketball League “Code of Conduct” and discussed it with my son/daughter. I understand the Code and realize that my son/daughter or I are subject to disciplinary measures should we violate the rules of this Code. I further understand that my behavior at all contests must set a positive example for my son/daughter to follow. I also realize that this also includes any guests who attend the contest with me or representing my child. I also understand that the Apollo-Ridge Viking Elementary Basketball League is for the benefit of the participants; not the parents, coaches and/or spectators. I agree to follow all rules included in the Code and to be a positive role model for children.

(Both parents should sign, if they both will be attending)

Signature

Read above Code of Conduct:

COACH: I acknowledge that I have received a copy of and read the Apollo-Ridge Viking Elementary Basketball League “Code of Conduct”. I understand the Code and realize that I am subject to disciplinary measures should I violate the code. I also understand that I have an obligation to follow all guidelines established by the Varsity Coach in this sport. I do agree to conduct myself in accordance with the rules of the “Code of Conduct” and with any other specific rules or guidelines established by the Parent Board of the Apollo-Ridge Elementary Basketball League.

Signature

After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at arelembasketball@gmail.com.