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2019-20 COACHES ONLY - Child Online Basketball Registration Form
THIS FORM IS FOR CHILDREN/PARTICIPANTS OF "CONFIRMED COACHES" ONLY!!!! IF YOU ARE "NOT" A CONFIRMED COACH (SUBMITTED A COACH APP), AND YOU USE THIS FORM, A REFUND WILL "NOT" BE PROVIDED AND WE WILL USE THIS SUBMISSION AS A DONATION...
Player First Name:
Player Last Name:
By checking this box I affirm that the spelling of your child's name is accurate and EEYB is not responsible for mispellings on the uniform!!
Returning Player (Played for EEYB during 2018-2019 season)
New Player (Did NOT play for EEYB during 2018-2019 season)
Child's Age as of 1/1/2020:
School Attending 2019-2020 Year:
Grade 2019-2020 Year:
NOTICE: UNIFORM SIZING MUST BE COMPLETED IN PERSON AT AN ON-SITE SIZING NO LATER THAN DECEMBER 2, 2019 (LOCATION TBD). EEYB will NOT order uniform if child is not sized and parent is responsible for paying additional $25 fee for seperate order!!!
Parent/Guardian First Name and Last Name:
Street Number and Name:
Cell Phone (No dashes):
Home phone (No dashes):
Work phone (No dashes):
EEYB'S EDUCATION REQUIREMENT:
EEYB works with Henrico County Board of Supervisors and School Board to heighten EDUCATION for our youth. Each year, we REQUIRE each child to submit a COPY OF THEIR LATEST REPORT CARD ON DECEMBER 2, 2019 (DURING UNIFORM SIZING). If the registered participant does not submit a copy, they will NOT BE ALLOWED TO RECEIVE THEIR UNIFORM NOR PARTICIPATE IN THE SEASON GAMES UNTIL THE REPORT CARD IS RECEIVED AND PROCESSED BY OUR MENTOR/EDUCATIONAL ADVISOR.
If your child’s average is LOWER THAN A 2.0 (Letter grade equivalent where primary grading is given), he/she will be required to attend a number of tutoring sessions. A signed contract (provided by EEYB) will need to be submitted by DECEMBER 20, 2019 or he/she will NOT be able to play the first game. If he/she does not complete all the sessions, he/she will not be allowed to start participating (Play in Games) until signed off from the tutor.
EEYB will help you work with HCPS or suggest private tutors to assist with coordinating tutoring sessions.
Thank you for your understanding as EDUCATION IS KEY TO THE SUCCESS OF A STUDENT ATHLETE!!!!
EEYB'S EDUCATION REQUIREMENT -------- BY CHECKING THIS BOX, I AGREE WITH THE BELOW EDUCATION STATEMENT AND WILL ABIDE ACCORDINGLY
Are you currently participating in other activities that could conflict with EEYB during the months of Dec and March:
If yes, please list the week night(s) child will NOT be able to participate in any EEYB activities:
*ALL players will be assessed during evaluation and placed on teams accordingly. Parents CAN NOT select their coaches or team.
*All NEW players must show original birth certificate or DMV issued ID in order to be eligible.
*YOUR REGISTRATION WILL NOT BE FINAL UNTIL (1) CHILD'S BIRTH CERTIFICATE OR DMV ID HAS BEEN SEEN AND VERIFIED BY AN EEYB REPRESENTATIVE AND (2) PLAYER and PARENT CODE OF CONDUCT FORM SUBMITTED.
By checking this box, I agree to allow EEYB to display pictures of my participant on the EEYB website or other league sponsored publication
List any known medical conditions and/or allergies:
List any required medications:
In case of an accident or illness, I hereby authorize a representative of EEYB to use his or her judgment in obtaining immediate medical care my the above named child.
I have read and understand the above information and by checking the attached box indicates my agreement with the terms set forth above.
EEYB offers tutoring and mentoring to our participants. Please check if you are interested in these services.:
*What tutoring subjects are of interest to you? (Select all that apply):
*What mentoring subjects are of interest to you? (Select all that apply):
Say No To Drugs
Despite all known and unknown risks, I hereby expressly and voluntarily remise, release, acquit, satisfy and forever discharge EEYB and staff, Henrico County and staff and Henrico Schools and staff and agree to hold it harmless of and from all, and all manner of action and actions or omission(s), cause and cause of action, suits, debts, dues, sums of money, accounts, reckonings, bonds, bills, specialties covenants, contracts, controversies, agreement, promises, variances, trespasses, damages, judgments, executions, claims and demands whatsoever, in law or in equity, including, but not limited to, any and all claims which allege negligent acts and/or omissions committed by EEYB and staff, Henrico County and staff and Henrico Schools and staff, whether the action arises out of any damage, loss, personal injury, or death to me or my child(ren)/ward(s), while participating in or as a result of participating in any of the ACTIVITIES. This Release of Liability, is effective and valid regardless of whether the damage, loss or death is a result of any act or omission on the part of EEYB and staff, Henrico County and staff and Henrico Schools and staff.
By checking this box I affirm that I have read and understand the Release of Liability Waiver and agree to abide by the terms therein.
Player and Parent Code of Conduct
PLAYER CODE OF CONDUCT
1. I will encourage good sportsmanship from fellow players, coaches, officials and parents at every game and practice by demonstrating good sportsmanship.
2. I will attend every practice and game that I can, and will notify by coach if I cannot.
3. I will do my very best to listen and learn from my coaches.
4. I will treat my coaches, other players, officials and fans with respect regardless of race, sex, creed, or abilities and I will expect to be treated accordingly.
5. I will control my emotions; avoid the use of abusive language or profanity, humiliating remarks, along with rude gestures or physical assault upon another player at any time.
6. I deserve to play in an environment that is free of drugs and alcohol and expect adults to refrain from their use at all youth sports events.
7. I will encourage my parents to be involved with my team in some capacity because it's important to me.
8. I will follow all EEYB rules/Code of Conduct, respecting at all time the property of others. Any ethic or code of conduct violations can or will result in an IMMEDIATE dismissal or suspension of board membership as voted by the Executive Board.
9. I will do my very best in school.
10. I will remember that sports are an opportunity to learn and have fun.
11. Shall follow the league rules/Code of Conduct. Any ethic or code of conduct violations can or will result in an IMMEDIATE dismissal or suspension of board membership as voted by the Executive Board.
By checking this box I affirm that the Player has read or had read to him/her the Player Code of Conduct and agree to abide by the terms therein.
PARENT 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 sporting events.
2. I will place the emotional and physical well-being of my child ahead of a personal desire to win.
3. I will insist that my child play in a safe and healthy environment.
4. I will support coaches and officials working with my child, in order to encourage a positive and enjoyable experience for all.
5. I will demand a sports environment for my child that is free of drugs and alcohol, and will refrain from their use at all youth sports events.
6. I will remember that the game is for youth-not for adults.
7. I will do my very best to make youth sports fun for my child.
8. I will refrain from using abusive language or profanity, humiliating remarks, along with rude gestures nor at any time will I engage in physical assault with or upon another person at any time.
9. I will ask my child to treat other players, coaches, fans, and officials, with respect regardless of race, sex, creed, or ability.
10. I promise to help my child enjoy the youth sports experience by doing whatever I can, such as being a respectable fan, assisting with coaching, or providing transportation to each practice and game.
11. I will be responsible for my children (siblings/friends) while on school property i.e. games and practices.
(a) Will ensure they remain in the gym area at all times and not roam the schools.
(b) Will accompany them if need to be outside the gym area.
12. Shall follow the league rules/Code of Conduct. Any ethic or code of conduct violations can or will result in an IMMEDIATE dismissal or suspension of board membership as voted by the Executive Board.
By checking this box I affirm that I have read the Parent Code of Conduct and agree to abide by the terms therein.
Fee Scale for On-Line Registration:
* September - October 31, 2019 Registration: $75 + $5.00 online processing fee. No multi-child discount.
* November Registration: $100 + $5.00 online processing free. No multi-child discount.
** PLEASE NOTE: October 31, 2019 is the final day for a coach child to be registered and receive the coach discount. No exception as this is helpful for placements. Thank you for your understanding.
Registration Fee Includes: New designed personalized game jersey, game shorts, insurance, games, and trophy.
Upon submission of this form, absolutely NO refunds will be given.
IF YOU ARE NOT A CONFIRMED COACH (i.e. already submitted an application, spoken with VP of BB, AND have an interview) YOUR REGISTRATION IS NOT VALID. YOU WILL RECEIVE A REFUND AND YOUR CHILD'S SPOT IS NOT CONFIRMED.
EEYB HAS THE RIGHT TO REJECT ANY REGISTRATION AT ANY TIME AND A REFUND WILL BE GRANTED.
By checking this box, I agree to the fee scale terms, no refund policy, and uniform sizing guidelines!
Date acknowledging the fee scale terms, no refund policy, and uniform sizing guidelines:
Office Use Only
Birth Certificate shown? (yes/no/na) __________
T __________ _____
B __________ _____
* indicates required fields
$80.00 - Sept - Oct 31, 2019: 1 Child Payment (Registration Fee + Processing Fees $5)
Team Paraphernalia Team T-Shirt (YS - AL)($15)
Team Paraphernalia Team T-Shirt (AXL - A5XL)($20)
East End Youth Basketball