Midland Park 2009-2010 Basketball Association

 Recreation Registration Form

Mail in Form BEFORE OCT. 31st, 2009

      M.P.B.A    P.O Box 459         M.P. NJ  07432

Eligible Applicants:           Girls - K to 9^th Grades

                                                 Boys - K to 11^th Grades

WWW.MIDLANDPARKSPORTS.COM/MPBA

RECREATION PROGRAM ONLY

Please circle one of the below categories: Registration Fee:

                   (circle Boy or Girl)                                     (Family Max $160)

Kindergarten: Boys & Girls Clinic                                           $55

1st & 2^nd:   Boys  / Girls - Instructional $65

Pee Wee:    Boys  / Girls in 3^rd & 4^th                                                                   $85

Juniors:      Boys  / Girls in 5^th & 6^th;                                                                 $85

Seniors:     Boys  / Girls in 7th & 8^th                                                                 $85

Upper Seniors: Boys in 9^th & 10^th   & 11^th                               $85

            We need Coaches and Assistants - please circle as appropriate

Parent Name  ______________ Coach        Assist-Coach      But need Rutgers Card

PLAYER INFORMATION

          ***********   PLEASE PRINT ALL INFORMATION   **********

First Name _________________________   Last Name ____________________________     

Date of Birth ___________        Age ___      Height _______   Gender:   Boy Girl    (circle one)

Address ____________________________  Town __________       

Phone # ______________________    Grade in Sept 2009____________

Parent Information – Please Print Full Name of Parent or Guardian

Name__________________________________         Phone # ___________________

Name__________________________________         Phone # ___________________

Email ______________________________________________________________

Parent / Guardian Signature:__________________________________________

Midland Park Basketball Athletic Code of Conduct

Interscholastic and youth sports programs play an important role in promoting the physical, social and emotional development of children. It is therefore essential for parents, coaches and officials to encourage youth athletes to embrace the values of good sportsmanship. Moreover, adults involved in youth sports events should be models of good sportsmanship and should lead by example by demonstrating fairness, respect and self-control towards coaches, volunteers, players, spectators and each other. It is also important for the board to represent the association and Basketball community in good faith by following and maintaining proper behavior and etiquette in all phases of recreation and travel basketball.

I therefore pledge to be responsible for my words and actions while attending, coaching, officiating or participating in any Midland Park recreation and/or travel basketball event and shall conform my behavior to the following code of conduct:

1.  I will not engage in unsportsmanlike conduct with any coach, parent, player, participant, official, or any other attendee.

2. I will not encourage my child, or any other person, to engage in unsportsmanlike conduct with any coach, parent, player, participant, official or any other attendee.

3. I will not engage in any behavior, which would endanger the health, safety or well being of any coach, parent, player, participant, official or any other attendee.

4. I will not encourage my child, or any other person, to engage in any behavior, which would endanger the health, safety or well being of any coach, parent, player, participant, official or any other attendee.

5. I will not engage in the use of profanity.

6. I will not encourage my child, or any other person, to engage in the use of profanity.

7. I will treat any coach, parent, player, participant, official or any other attendee with respect regardless of race, creed, color, national origin, sex, sexual orientation or ability.

8.  I will encourage my child to treat any coach, parent, player, participant, official or any other attendee with respect regardless of race, creed, color, national origin, sex, sexual orientation or ability.

9.  I will not engage in verbal or physical threats or abuse aimed at any coach, parent, player, participant, official or any other attendee.

10.  I will not encourage my child, or any other person, to engage in verbal or physical threats or abuse aimed at any coach, parent, player, participant, official or any other attendee.

11.  I will not initiate a fight or scuffle with any coach, parent, player, participant, official or any other attendee.

12. I will not encourage my child, or any other person, to initiate a fight or scuffle with any coach, parent, player, participant, official or any other attendee.

I hereby agree that if I fail to conduct myself to the foregoing I will be subject to disciplinary action, including but not limited to the following in any order or combination:

1. Verbal warning issued and or written warning issued.

2. Suspension or immediate ejection. Forfeiture of Coaching Rights and Board Position for one year

3. Season suspension issued. Permanent forfeiture of Coaching Rights and Board Positions

In addition, I hereby realize that I will not be permitted to attend a Midland Park recreation and/or travel Basketball event without signing below. Board Members, Coaches and Managers will forfeit their positions by failing to sign.

Father’s Name     __________________________

Signature              __________________________

Date                       __________________________

Mother’s Name    ___________________________

Signature              ___________________________

Date        ___________________________