NRVCA Athletic Registration Form

Player Name

Date of Birth

Sport

Level

Home Address

City

State

Zip

Parent / Guardian #1 Name

First NameLast Name

Parent / Guardian # 1 Cell

Please enter a valid phone number.Format: (000) 000-0000.

Parent / Guardian # 1 Email

example@example.com

Parent / Guardian #2 Name

First NameLast Name

Parent / Guardian # 2 Cell

Please enter a valid phone number.Format: (000) 000-0000.

Parent / Guardian #2 Email

example@example.com

Family’s Church and Pastor

Does your church have a basketball gym or athletic fields?

Church Facility Details

Emergency Contact Name

First NameLast Name

Emergency Contact Phone

Please enter a valid phone number.Format: (000) 000-0000.

Relationship to Student

Does this student have any special medical conditions?

If yes, please describe the medical conditions

Medical Insurance Provider

Policy Number

Student’s Primary Physician

First NameLast Name

Physician Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

We, as a parent/guardian, grant permission for our son/daughter to participate in the above program and release NRVCA, the Board of Directors, and Coaches from liability for damages or injuries that might be incurred during the operation of this program. We assure he/she is in good physical health as examined by a physician. ** In the event we cannot be reached, we give permission for our child to receive emergency medical care. We verify that the above information is true and complete to the best of our knowledge.

We are also aware that our child is required to conduct himself/herself in a manner representative of our Christ-centered sports Association. As a parent/guardian, we will strive to be good examples of Christian character at all NRVCA sporting events. We agree to allow the Coaches and Board of Directors to enforce the rules set forth for each program, as well as those listed in the Code of Conduct. We understand that, in the improbable event that we or our son/daughter become a habitual or severe offender, we may be asked to leave the program, wherein we will not be entitled to a refund of registration fees.

We have read and will comply with the information set forth on the NRVCA registration form and Code of Conduct. Separate forms with parents’ and players’ signatures are required for each player.

Parent / Guardian #1 Initials

Parent / Guardian #2 Initials

Player Initials

1. All members of the Trailblazer program will show honor to God, families, coaches, referees, and teammates in actions and words as representatives of God, their families, and the Trailblazers program.

2. NRVCA is a Christian association with prayer at all events, practices, and games.

3. Players and Parents will be supportive of other players/coaches; any concerns should be handled privately.

4. Players should be pursuing academic success in all their classes, according to their parents’ standards.

5. Players are expected to be at all team events, games, and practices.

6. Playing time is determined by each team’s coach. If there is a question about playing time, the player should first bring it up with the coach. Then the parent should come with the player to discuss.

7. The coaches will determine which players will play for each team. Coaches are responsible for monitoring and correcting the behavior of the players with the cooperation of the parents.

8. No player should be allowed to participate who has turned 19 prior to August 1st, has passed the GED, or graduated high school. He/She should have a notice of intent to homeschool on file with the city/county. Upon request, families must present a birth certificate and the letter received from their city/county school board showing their status as a homeschooled student.

9. Players should dress in a conservative manner, befitting a Christian young man/woman, while at all NRVCA functions as a representative of Christ, our association, and the home-schooling community. After a warning, if it continues, the coach may remove the player.

10. No use of profanity, crude gestures, or inappropriate behavior by players, parents, or fans at any NRVCA function will be tolerated and result in immediate suspension.

11. Families will be willing to put forth every reasonable effort to participate in the fund-raising programs deemed necessary to insure proper maintenance of required equipment and facilities.

12. We have read and agreed to comply with this Code of Conduct as players and parents of NRVCA.

Parent / Guardian #1 Signature

Parent / Guardian #2 Signature

Player Signature

Submission Date

Date

NRVCA Athletic Registration Form

EMERGENCY INFORMATION

NRVCA TRAILBLAZERS - Code of Conduct