Please select sport(s) you are registering for:(Required)Basketball/K-8th ($75)Cheer/all grades ($50)Archery/8yr-18yr($50 per season)Baseball/boys ($100) (NOT OPEN)Fall Soccer/co-ed ($60) (NOT OPEN)Volleyball/girls 3rd-8th ($75) (NOT OPEN)Student Name(Required) First Last School Child Attends(Required)Headwaters Christian AcademyHome SchoolOther (add school name in next field)Name of school Short/Pant size(Required)Youth XSYouth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XLShirt size(Required)Youth XSYouth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XLCurrent Grade Level(Required)PKK1st2nd3rd4th5th6th7th8th9th10th11th12thPreferred Jersey #(both numbers 0-5)Age(Required)Date of Birth(Required) MM slash DD slash YYYY Gender(Required)MaleFemaleAre there any medical conditions that we should be made aware of?(Required)YesNoList medical condition Parent or Guardian Name(Required) First Last Email(Required) Cell Phone(Required)Text OK?(Required)YesNoI will volunteer in the following area(Required)Entry TableConcessionsCoachAssistant CoachAddress(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Please read the statements below, check the Yes box as you agree to each statment and then provide your signature below.I, the undersigned parent or guardian of the above-named participant in the youth activity sponsored by HCA, hereby gives my consent to his/her practicing, playing and otherwise participating in said related activity.(Required)I, the undersigned parent or guardian of the above-named participant in the youth activity sponsored by HCA, hereby gives my consent to his/her practicing, playing and otherwise participating in said related activity. Yes I affirm that to the best of my knowledge the above-named child is physically capable of participating in the sport or activity named above.(Required)I affirm that to the best of my knowledge the above-named child is physically capable of participating in the sport or activity named above. Yes I further understand that the responsibility for identifying medical needs of the above-named child is mine and not that of HCA, its coaches, officials, or representatives.(Required)I further understand that the responsibility for identifying medical needs of the above-named child is mine and not that of HCA, its coaches, officials, or representatives. Yes I also understand that my child will not be permitted to practice or play in games if I am behind on tuition payments or in debt to the school.(Required)I also understand that my child will not be permitted to practice or play in games if I am behind on tuition payments or in debt to the school. Yes 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, including travel 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, HCA and its staff and any other person constituting a part of any team or program in any capacity whatsoever from any liability because of injury or loss as a result of or incident to my child’s involvement.(Required)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, including travel 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, HCA and its staff and any other person constituting a part of any team or program in any capacity whatsoever from any liability because of injury or loss as a result of or incident to my child’s involvement. Yes PCAA PARENT CODE OF CONDUCT - As parent(s) or guardian of a student-athlete, I/we acknowledge that interscholastic sports are part of the educational experience and serve primarily to promote positive personal development. I understand that the desire to win is never to be placed ahead of the spiritual, academic, social, emotional, physical well-being of the students. I therefore pledge to: A. Positively support my student-athlete: • Provide positive support to my student-athlete, win or lose. • Emphasize effort, skill development, teamwork, and love of the game. • Be sure my student-athlete attends all practices. • Attend required meetings and as many games as possible. • Actively support my student-athlete in abiding by the Student-Athlete Code of Conduct • Actively contribute to team morale. B. Personally model the highest standards of sportsmanship at games: • Let the coach do his job: refrain from yelling criticism and advice. • Let the players play: refrain from shouting instructions or criticisms at my student-athlete or at others. • Let the officials do their job: accept their decisions, and refrain from negative comments and boos. • Cheer for the positive: good effort, good plays, good teamwork, and good sportsmanship. • Respect the opposing team and refrain from derogatory comments. • Refrain from catcalls, insults, foul language, or violent behavior. C. Resolve issues with coaches, teammates, or athletic personnel appropriately: • Follow school policy by not presenting grievances during or after a game. • Request a meeting at school with the coach to discuss problems or issues. • If the issue remains unresolved, request a meeting with that specific Sport Coordinator. I further understand that I/we may be ejected from a game and prohibited from attending future athletic events if my/our behavior violates the standards of PCAA.(Required)PCAA PARENT CODE OF CONDUCT - As parent(s) or guardian of a student-athlete, I/we acknowledge that interscholastic sports are part of the educational experience and serve primarily to promote positive personal development. I understand that the desire to win is never to be placed ahead of the spiritual, academic, social, emotional, physical well-being of the students. I therefore pledge to: A. Positively support my student-athlete: • Provide positive support to my student-athlete, win or lose. • Emphasize effort, skill development, teamwork, and love of the game. • Be sure my student-athlete attends all practices. • Attend required meetings and as many games as possible. • Actively support my student-athlete in abiding by the Student-Athlete Code of Conduct • Actively contribute to team morale. B. Personally model the highest standards of sportsmanship at games: • Let the coach do his job: refrain from yelling criticism and advice. • Let the players play: refrain from shouting instructions or criticisms at my student-athlete or at others. • Let the officials do their job: accept their decisions, and refrain from negative comments and boos. • Cheer for the positive: good effort, good plays, good teamwork, and good sportsmanship. • Respect the opposing team and refrain from derogatory comments. • Refrain from catcalls, insults, foul language, or violent behavior. C. Resolve issues with coaches, teammates, or athletic personnel appropriately: • Follow school policy by not presenting grievances during or after a game. • Request a meeting at school with the coach to discuss problems or issues. • If the issue remains unresolved, request a meeting with that specific Sport Coordinator. I further understand that I/we may be ejected from a game and prohibited from attending future athletic events if my/our behavior violates the standards of PCAA. Yes PCAA STUDENT ATHLETE CODE OF CONDUCT - Athletes will abide by all school policies, team rules, the rules and policies of PCAA. Character • Abide by all government laws, school rules, and athletic department rules • Exercise self-discipline on and off the playing surface • Own up to the responsibility of being a good role model that peers and younger students can look up to • Exhibit pride in dress and behavior while traveling to and from sporting events • Show respect for members of the school and the community, opponents, officials and opposing fans Academics • Be a responsible student, which includes being prepared, and completing assignments on time. • Follow the school’s policies regarding academic integrity and honesty. • Be respectful to teachers, administration, and fellow students. Sportsmanship • Competitive rivalries and fearless competition are encouraged however, athletes are expected to compete with class. • Respect oneself, teammates, coaches, officials, opponents, and property. • There will be no taunting, fighting, looking to the stands, unsportsmanlike conduct or profanity of any kind. • Players, parents, and fans are expected to positively represent Christ and PCAA and its members. • Go above and beyond what is expected; for example, hand the ball to officials, thank the crowd for their support and clean up the bleachers and bench area. • Go the extra mile, exceed expectations, and leave places better than you found them. Consequences Inappropriate behavior will result in reduced playing time, game suspension or dismissal from the team. IN accordance with individual sport rules, any team member being ruled out of a contest by an official because of unsportsmanlike behavior shall be disqualified from athletic competition for the given game and one (1) additional game. The athlete will also be required to meet with the head coach and a member of the PCAA board prior to returning to activities to ensure our high standards of conduct are re-established. School Suspension Any student on suspension from school is ineligible to participate in practice sessions or to represent the school in any extracurricular activities. Suspended students may not attend extracurricular activities. Suspension through a given day is considered as being through to the beginning of the next school day.(Required)PCAA STUDENT ATHLETE CODE OF CONDUCT - Athletes will abide by all school policies, team rules, the rules and policies of PCAA. Character • Abide by all government laws, school rules, and athletic department rules • Exercise self-discipline on and off the playing surface • Own up to the responsibility of being a good role model that peers and younger students can look up to • Exhibit pride in dress and behavior while traveling to and from sporting events • Show respect for members of the school and the community, opponents, officials and opposing fans Academics • Be a responsible student, which includes being prepared, and completing assignments on time. • Follow the school’s policies regarding academic integrity and honesty. • Be respectful to teachers, administration, and fellow students. Sportsmanship • Competitive rivalries and fearless competition are encouraged however, athletes are expected to compete with class. • Respect oneself, teammates, coaches, officials, opponents, and property. • There will be no taunting, fighting, looking to the stands, unsportsmanlike conduct or profanity of any kind. • Players, parents, and fans are expected to positively represent Christ and PCAA and its members. • Go above and beyond what is expected; for example, hand the ball to officials, thank the crowd for their support and clean up the bleachers and bench area. • Go the extra mile, exceed expectations, and leave places better than you found them. Consequences Inappropriate behavior will result in reduced playing time, game suspension or dismissal from the team. IN accordance with individual sport rules, any team member being ruled out of a contest by an official because of unsportsmanlike behavior shall be disqualified from athletic competition for the given game and one (1) additional game. The athlete will also be required to meet with the head coach and a member of the PCAA board prior to returning to activities to ensure our high standards of conduct are re-established. School Suspension Any student on suspension from school is ineligible to participate in practice sessions or to represent the school in any extracurricular activities. Suspended students may not attend extracurricular activities. Suspension through a given day is considered as being through to the beginning of the next school day. Yes Parent or Guardian Signature