HFAA SPORTS REGISTRATION FORM
PLEASE COMPLETE "ONE" Holy Family Athletic Association (HFAA) REGISTRATION FORM PER ATHLETE/PLAYER
Registration is NOT complete until "ALL" HFAA registration signatures are received.
Required registration fees are non-refundable:
*Payment check written out to HFAA - indicate sport on memo line or
*PayPal recipients - please submit paid receipt with forms
*Work-bond check written out to HFAA - Basketball and Volleyball registrations ONLY.
If HFS student submit through school ATTN: HFAA c/o (name of sport).
All others drop off or mail payment to...
Holy Family School
ATTN: HFAA c/o (name of sport)
17 Convent Ave
Nazareth, PA 18064
NAME OF SPORT
TRACK & FIELD
VOLLEYBALL (GIRLS ONLY)
INSTRUCTIONAL (K-2nd) - indicate sport name in next question
INSTRUCTIONAL SPORT NAME
Athlete's Last Name
Athlete's First Name
Date of Birth
Grade entering 9/01
SHIRT SIZE (Youth)
SHIRT SIZE (Adult)
Mother's Name (First Last)
Mother's Cell Phone Number
Mother's E-mail Address
Father's Name (First Last)
Father's Cell Phone Number
Father's E-mail Address
Is your child a Holy Family School Student or Holy Family Parish Member?
Holy Family School Student
Holy Family Parish Member
None of the Above (Please complete the next question)
If your child is a member or student other than Holy Family School or Parish please indicate in space provided below.
Family Doctor's Name
Family Doctor's Phone Number
MEDICAL INSURANCE HEALTH PLAN CARRIER:
Emergency Contact Person (other than parents)
Emergency Contact Phone Number
Other Medical Concerns
The undersigned parent or legal guardians intending to be legally bound agree:
1. That the undersigned participant has our permission to participate in sports activity under the direction of the Holy Family Athletic Association.
2. To return all equipment and uniforms, clean and in good condition, upon separation from his/her team.
3. To release Holy Family Athletic Association, Holy Family School, Holy Family Parish and their agents, coaches and assigns from any and all liability, responsibility, or obligation in the event of an accident, regardless of causes or consequences by reason of any mishap, accident or injury received by said participant in transportation, play, game, exhibition, practice or related activity.
4. That this release will be binding on the undersigned parent(s), legal guardians, participants and their heirs, executors or administrators.
Parent or Legal Guardian agree to the terms of the above listed release:
Parents' CYO Sports Pledge
I/We, the undersigned, am/are registering my/our son/daughter in a Catholic athletic program,which will emphasize Christian values during practice and games. Although my/our child’s team will practice hard and play their games to the best of their ability, faith in Jesus Christ - not just winning - will be the most important goal of the season.
I/We realize that my/our child is to behave in a Christian manner throughout the season, and thatfamily and friends who come to his/her games are also to act in a manner appropriate for aprogram dedicated to living the faith we profess. Any violation will result in removal from theevent, and/or refused admittance to CYO-sponsored events. A spectator is understood to meananyone in attendance at an event, including parents, family members, and/or friends. Anyspectator who displays poor sportsmanship, or interferes with the conduct of a CYO event maybe removed from the event by an official/referee, their team coach, a host-site gym supervisor, aCYO District Commissioner or Administrative Official. In such situations, it is the discretion of the CYO District Commissioner, following discussion with OYYAFM, as to whether a spectator will be barred from attendance at subsequent CYO events.
I/We also realize that my/our child will be expected to attend Sunday Mass weekly as well as Holy Days of Obligation and be enrolled in a Catholic School or attend the Parish Religious Education Program (including Youth Ministry Program). Realizing the profound influence my/our example has on our child(ren), I/we will attend Sunday Masses and Holy Days of Obligation as a strong witness of my/our faith.
I/We realize that inappropriate behavior on the part of my/our child, or family members, could result in my/our child’s suspension from the team. (see Participants’ and Spectators’ Code of Conduct).
I/We pledge to do my/our part to witness to Christian values at home and at games, to support the coaches in their attempt to develop the team into a faith community, and to take seriously the faith dimension of the team’s efforts.
Diocese of Allentown CYO, 2019-2020
Parent/Guardian Printed Name as Signature (CYO Sports Pledge)
Participants’ Code of Conduct
With Almighty God as my witness, I promise to adhere by the following Contract/Covenant:
1. I will encourage good sportsmanship from my fellow players, coaches, officials and parents at every
game, scrimmage and practice.
2. I will always participate in a positive manner, reflecting Christian values.
3. I will always treat teammates, opponents, coaches, officials and parents with respect and will expect to be treated accordingly.
NO PLAYER SHALL:
1. Refuse to abide by an official’s decision.
2. Be guilty of gestures indicating his/her objections to decision by officials or coaches, etc., such as throwing equipment.
3. Be guilty of inflicting any abuse upon any official for any real or imaginary wrong decision or judgment.
4. Be guilty of an abusive verbal or written attack, including social media upon any player, coach, official, or spectator.
5. At any time, lay hands upon, push, shove, strike, or threaten to strike an official, coach, or spectator.
6. Be guilty of a physical attack as an aggressor upon any player.
7. Show disrespect for the property of another team or the facility being used for the contest by activities such as vandalism or destruction of property.
Penalties: Within 2 consecutive calendar years:
3 game suspension
10 game suspension dismissal from CYO program
Note: Games that are scheduled but not played due to weather or other circumstances do not fulfill the suspension.
Violation of the above conduct rules should be reported in writing to the Diocesan CYO District Commissioner within 48 hours. Investigation and discussion of violation will occur, penalty determined and then approved by the District Priest Chaplain. If a penalty is levied, OYYAFM must be informed, in writing, within one week of the decision.
Districts must abide by these minimum standards. They are free to have District regulations, which may be more restrictive.
Diocese of Allentown CYO, 2019-2020
Student-Athlete Printed Name as Signature (CYO Code of Conduct)
Parent/Athlete Concussion Information Sheet
CONCUSSION DANGER SIGNS
In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. An athlete should receive immediate medical attention if after a bump, blow, or jolt to the head or body s/he exhibits any of the following danger signs:
• One pupil larger than the other
• Is drowsy or cannot be awakened
• A headache that not only does not diminish, but gets worse
• Weakness, numbness, or decreased coordination
• Repeated vomiting or nausea
• Slurred speech
• Convulsions or seizures
• Cannot recognize people or places
• Becomes increasingly confused, restless, or agitated
• Has unusual behavior
• Loses consciousness (even a brief loss of consciousness should be taken seriously)
WHY SHOULD AN ATHLETE REPORT THEIR SYMPTOMS?
If an athlete has a concussion, his/her brain needs time to heal. While an athlete’s brain is still healing, s/he is much more likely to have another concussion. Repeat concussions can increase the time it takes to recover. In rare cases, repeat concussions in young athletes can result in brain swelling or permanent damage to their brain. They can even be fatal.
WHAT SHOULD YOU DO IF YOU THINK YOUR ATHLETE HAS A CONCUSSION?
If you suspect that an athlete has a concussion, remove the athlete from play and seek medical attention. Do not try to judge the severity of the injury yourself. Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says s/he is symptom-free and it’s OK to return to play. Rest is key to helping an athlete recover from a concussion. Exercising or activities that involve a lot of concentration, such as studying, working on the computer, or playing video games, may cause concussion symptoms to reappear or get worse.
After a concussion, returning to sports and school is a gradual process that should be carefully managed and monitored by a health care professional.
It’s better to miss one game than the whole season. For more information on concussions, visit:
Student-Athlete Printed Name as Signature (Concussion)
Parent/Guardian Printed Name as Signature (Concussion)
Athlete/Parent/Guardian Sudden Cardiac Arrest Symptoms and Warning Signs Information Sheet andAcknowledgement of Receipt and Review Form
What is sudden cardiac arrest?
Sudden cardiac arrest (SCA) is when the heart stops beating, suddenly and unexpectedly. When this happens blood stops flowing to the brain and other vital organs. SCA is NOT a heart attack. A heart attack may cause SCA, but they are not the same. A heart attack is caused by a blockage that stops the flow of blood to the heart. SCA is a malfunction in the heart’s electrical system, causing the heart to suddenly stop beating.
How common is sudden cardiac arrest in the United States?
There are about 300,000 cardiac arrests outside hospitals each year. About 2,000 patients under 25 die of SCA each year.
Are there warning signs?
Although SCA happens unexpectedly, some people may have signs or symptoms, such as:
- shortness of breath
- difficulty breathing
- racing or fluttering heartbeat (palpitations)
- syncope (fainting)
- fatigue (extreme tiredness)
- chest pains
These symptoms can be unclear and confusing in athletes. Often, people confuse these warning signs with physical exhaustion. SCA can be prevented if the underlying causes can be diagnosed and treated.
What are the risks of practicing or playing after experiencing these symptoms?
There are risks associated with continuing to practice or play after experiencing these symptoms. When the heart stops, so does the blood that flows to the brain and other vital organs. Death or permanent brain damage can occur in just a few minutes. Most people who have SCA die from it.
Act 59 – the Sudden Cardiac Arrest Prevention Act (the Act)
The Act is intended to keep student-athletes safe while practicing or playing. The requirements of the Act are:
Information about SCA symptoms and warning signs.
- Every student-athlete and their parent or guardian must read and sign this form. It must be returned to the school before participation in any athletic activity. A new form must be signed and returned each school year.
- Schools may also hold informational meetings. The meetings can occur before each athletic season. Meetings may include student-athletes, parents, coaches and school officials. Schools may also want to include doctors, nurses and athletic trainer.
Removal from play/return to play
- Any student-athlete who has signs or symptoms of SCA must be removed from play. The symptoms can happen before, during or after activity. Play includes all athletic activity.
- Before returning to play, the athlete must be evaluated. Clearance to return to play must be in writing. The evaluation must be performed by a licensed physician, certified registered nurse practitioner or cardiologist (heart doctor). The licensed physician or certified registered nurse practitioner may consult any other licensed or certified medical
I have reviewed and understand the symptoms and warning signs of SCA.
PA Department of Health: Sudden Cardiac Arrest Symptoms and Warning Signs Information Sheet and Acknowledgement of Receipt and Review Form. 7/2012
Parent/Guardian Printed Name as Signature (Sudden Cardiac Arrest)
ONE-TIME FEE SCHEDULE - Payable by check to HFAA. (If season does not happen due to COVID then fees will be refunded)
1 grade school athlete = $100
2 grade school athletes = $150
3 or more grade school athletes = $200
Instructional = $50 individual per athlete
1 high school athlete = $120 (includes personal jersey)
REGISTRATION FEE TOTAL :
REGISTRATION FEE CHECK NUMBER OR PAYPAL RECEIPT NUMBER & DATE
WORK-BOND - $100 check must be submitted with registration for...
*Basketball and Volleyball only
*Instructional K-2nd = no work-bond required
WORK-BOND CHECK NUMBER:
Parent Volunteers are needed for our association to be successful in the task of coaching and guiding our children. If you can help, please check off any of the services.
Polzer Tournament Coordinator
Snack-Stand Scheduler (as needed)
HFAA Member (see website for details)
Any Sports/HFAA Coordinator
THANK YOU FOR CHOOSING HFAA SPORTS - GO CHIEFTAINS!
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service