Fall 2016
DC SPEED TRACK CLUB
FALL REGISTRATION FEES
Registration Fees for the Outdoor Season (September – mid-November) are as follows:
Description Quantity Fee
Cross Country with USATF membership: $90.00
Cross Country without USATF membership: $70.00
Cross Country Practice Only $50.00
Fall Strength and Conditioning Sessions $50.00
TOTAL AMOUNT DUE @ REGISTRATION
(If financial arrangements are needed, please contact Cynthia McEwen at [email protected] or 202-607-0376)
OFFICIAL UNIFORM
All athletes are required to purchase the official team uniform for all local and national meets. The cost of the official uniform is $71.00 - $84.00. This includes one pair of running shorts and one coordinating shirt. In the event that uniforms are unavailable at the time of competition, athletes can wear the official DC Speed tee shirt and black running shorts (available at most area sporting goods retailers), but purchase of the uniform is required for continued participation.
Purchase of additional uniform items is available. These items include warm-ups, equipment bags and DC Speed Supporter and extra athlete T-Shirts. One athlete shirt is included in the cost of registration.
Prefix the size with “A-“ for Adult and “Y-“ for Youth. Indicate the sizes as follows: A-3X, 2X, 1X, XL, L, M, S and Y-XL, L, M, S, XS.
Item Example Order:
Price Ea.
$50.00
Quantity 2
Sizes A-L ; Y-L
TOTAL
$100.00
Official Uniform – Top – Youth $45.00 Official Uniform – Shorts – Youth $25.00 Official Uniform – Top – Adult $55.00 Official Uniform – Shorts – Adult $30.00
Team Supporter T-Shirt $25.00 See Booster.Com to order
Additional Youth T-Shirt $20.00
2 Piece Warm- Up Suits $65.00
Equipment Bag – Large $35.00
Embroidery $10.00
TOTAL AMOUNT DUE @ REGISTRATION
(If financial arrangements are needed, please contact Cynthia McEwen at [email protected] or 202-607-0376)
To pay via cash, check or credit card, please complete and print the registration forms and submit with your payment method to either the President or the Treasurer. Checks should be made out to "D.C. Speed" with
the athlete's name and type of payment (e.g., registration, uniform, etc.) in the memo field.
DC SPEED TRACK CLUB
ATHLETE MEDICAL FORM
To be completed by the Parent or Guardian for each Athlete being registered
Due to the strenuous nature of some activities, parents are urged to consult with their child’s physician concerning his/her fitness to participate in the sport of track and field. All activities present certain inherent risks and hazards for which the athlete and his/her parent or guardian assumes all responsibility.
Athlete Name: Date of Birth:
Personal Health History
QUESTIONS YES NO
1. Has or had injuries requiring medical attention.
2. Has had any surgical procedures.
3. Has been hospitalized.
4. Has within the last 3 months had an illness lasting longer than 1 week.
5. Takes medication now or regularly.
6. Has a condition currently under a physician’s care.
7. Has food/medication/environmental allergies that may require emergency care.
8. If you answered “YES” to any of the above, please explain in detail. Please note any significant health history, conditions, communicable illnesses, or restrictions that may affect the athlete’s ability to participate in a sport:
9. Has passed a vision screening in the last year.
10. Has passed a hearing screening in the last year.
11. Has received an age-appropriate health screening within the last year.
12. Is current on all required vaccinations.
13. Has seen a dentist within the last year.
14. Has been cleared by a healthcare provider to participate in a competitive sport.
15. If you answered “NO” to any of the above, please explain in detail.
16. Please list any special or recurrent medical problems the athlete has and any special instructions you may have for your child (e.g., allergies, asthma, seizures, diabetes, etc.)
PARENT / GUARDIAN INFORMATION
Parent/Guardian #1 Name:
Mobile Phone:
Home Phone:
E-Mail Address:
Parent/Guardian #2 Name:
Mobile Phone:
Home Phone:
E-Mail Address:
Emergency Contact:
Mobile Phone:
Home Phone:
E-Mail Address:
MEDICAL COVERAGE DETAILS
Name of Primary Insured: Insurance Provider:
Group Number: Member ID:
Name of Athlete’s Physician: Physician’s Phone Number:
MEDICAL PERMISSIONS
Initials ________ I have completed the Athlete Medical Form completely and accurately and to my knowledge, there are no physical or other conditions that may interfere with my child’s participation in the DC Speed Track Club.
Initials ________ I understand that participation in track and field presents the possibility of injury. I agree not to hold the DC Speed Track Club, DC Speed Track & Field Booster Club, DC Department of Parks and Recreation, or the DC Government, or any officers, directors, employees, coaches or agents of the above named entities liable for injuries my child may suffer or for any other cause related to his/her participation in the track and field program.
Initials ________ I understand that the DC Speed Track Club does not assume responsibility for any accidents or medical, dental, hospital, or other expenses incurred as a result of an accident while traveling to or from, or participating in the activities of the club. I further understand that my child will not be covered by health insurance provided by the Club and that I will be responsible for all expenses arising out of any injuries sustained by my child.
Initials ________ I hereby approve my child’s participation in the track program and consent to allow DC Speed coaches, board members or volunteers to seek emergency treatment (including anesthesia) for my child and make any necessary decisions concerning his/her health and welfare, including medical treatment, in my absence.
Please sign and date below in the appropriate box.
Parent/Guardian #1 Signature: Date:
Parent/Guardian #2 Signature: Date:
DC SPEED TRACK CLUB
PARENT/GUARDIAN VOLUNTEER SURVEY
An ancient proverb says,” It takes a village to raise a child.” Put in simple terms it means that each of us must become involved in the development of our youth. The parents are the backbone of this track club. The DC Speed Track Club is better able to meet and exceed our youth athletes’ needs by using your talents and resources.
Your help is needed at all times. We sincerely hope you will offer your assistance by volunteering and by helping when called upon. Therefore please check below next to the functions that you can help to provide during this track season and post season.
Athlete/s Name(s):
Parent(s)/Guardian(s) Names:
I CAN VOLUNTEER TO PROVIDE ASSISTANCE WITH…
Photocopying Meet Management Travel Assistance
Photography Communications Typing
Public Relations Uniform Ordering / Distribution Statistics
Coaching Fundraising / Event Planning Membership
Meet Food/Beverages After-School Practice Carpool Awards Banquet
Also, the DC Speed Track Club values its parent’s/guardian’s input as to ways we can improve our program and activities that we can plan for the children. Please tell us below what you would suggest to make this track year more enjoyable and successful.
Suggestions:
Finally, each year our athlete’s outgrow their spikes and/or uniforms. If you are able to donate your child athlete’s spikes and/or uniforms from a prior season – please indicate so below. Please be reminded that the uniform donations should be laundered and the shoes deodorized before providing them to the club and/or another child athlete for use.
Track Uniform Donation? Size(s):
Track Spike Donation? Size(s):
Track Warm-Up Donation? Size(s):
Track T-Shirt Donation? Size(s):
FOR ADMINSTRATIVE USE ONLY:
Registration Fee(s): Birth Certificate(s): Volunteer Survey: Medical Form:
Issued Uniform(s): Issued T-Shirt(s): Policy Statement: Parent COC:
USATF/AAU Membership: Registration Entered Online: Sportsmanship Contract and Liability Waiver
Athlete COC:
1. DC Speed Track Club will recognize and address members’ concerns and provide as much information as possible through parents/coaches meetings. We are committed to free and open communication among all members. The Club acknowledges that our success is dependent upon each member’s contribution to the dialogue.
2. All members shall treat each other equally, as we would like to be treated, regardless of one’s status, and all club members, board members, and coaches shall recognize and reward excellence in volunteerism, regardless of friendship or other bias. Any member, including board members and coaches, that demonstrate unsportsman- like conduct may be immediately removed from the membership.
3. The C lub has zero tolerance for verbal abuse, fighting, bullying and alcoholic beverage consumption by the membership during any Club authorized events or practices. Any member, guest, athlete, etc. found to be in breach of this provision may be immediately dismissed from the C lu b and from the PVA and USATF/AAU without refund or review.
4. Any member who has a concern or issue in regard to the Club’s operations should bring the issue immediately to the Executive Board’s attention so that the Club can continue to strive for excellence and work together as a cohesive unit to identify opportunities for improvement.
5. The Club will maintain an environment in which its members are free to express their opinions, offer suggestions on Club-related issues, and participate in club-sponsored activities, committees, or meets without fear of retaliation.
6. All financial obligations must be met by members before the established submission date for issuance of official USA Track and Field membership numbers. For members who register after this date, all financial obligations are due at the time of registration. No member shall participate in any meet until arrangements have been made with the financial officers of the Club.
7. It is the policy of the club that any member who writes an insufficient check to the Club will be assessed a
$50.00 fee and all future financial transactions with the Club will be made in the form of cash, money order or certified check.
8. Criteria for selection of coaches will not be based on the fact that a person was in that position before, but based upon a process of accepting applications from all interested parties and making the selection on the merit of the commitment and experience of the applicant.
9. Written requests must be submitted for approval of all purchases for the Club.
10. A written report on all fundraising events and efforts must be submitted detailing both expenditures and monies collected. Signatures of all parties involved is required.
11. A monthly financial report will be available upon request to any member in good financial standing.
12. DC Speed Track Club does not assume responsibility for any accidents or medical, dental, hospital, or other expenses incurred as a result of an accident while traveling to or from, or participating in, the activities of the Club.
Please sign, date and return with the registration materials.
I have read and agree to the policy statements established by the DC Speed Track Club.
Parent/Legal Guardian Signature: Date:
Parent/Legal Guardian Signature: Date:
DC SPEED TRACK CLUB
SPORTSMANSHIP CONTRACT AND LIABILITY WAIVER
As a Parent/Guardian of an athlete that is requesting permission to participate in the USA Track and Field (USATF) or Amateur Athletic Union (AAU) – Potomac Valley Association (PVA) – DC Speed Track Club (DC Speed), I understand that sportsmanship and proper conduct (whether it be verbal or physical) is REQUIRED of me, my athlete(s) and my guest(s). Failure to conduct myself in a proper, professional and sportsmanlike manner, failure to ensure that my athlete(s) conduct him/herself in a sportsmanlike manner, and failure to ensure that my guest(s) conduct him/herself in a sportsmanlike manner may result in my family being dismissed from DC Speed, the association (PVA) and USATF/ AAU. Moreover, my dismissal will occur without refund of any kind and without review should DC Speed find that my behavior, that of my athlete, or that of my guest(s) was:
• offensive
• obscene
• vulgar
• illegal
• indecent
• unsportsmanlike
• contributing to the delinquency of a minor
• any other malconduct brought before the DC Speed Executive Board or Board of Directors
I hereby acknowledge that I have read this Sportsmanship Contract and Liability Waiver, the Parents’ Code of Conduct and the Athletes’ Code of Conduct. I also agree, by my signature below, that I “consent” to the terms written herein and “waive liability” of any coach, staff, member, parent and other representative of USATF/AAU, PVA and DC Speed for any dismissal that occurs as a result of this contract. Moreover, I AM AGREEING to conduct myself in a mature and professional manner; to ensure that my athlete(s) and guest(s) honor that same commitment, and understand that failure to do so may result in the penalty of dismissal. I specifically understand and agree as follows:
• USATF/AAU, PVA and DC Speed do not tolerate profanity, bad sportsmanship, dangerous play, fighting, destruction of property, and the like. I am agreeing to refrain from these behaviors and other similar conduct as they are undesirable to the USATF/AAU, PVA and DC Speed and may result in my dismissal from the Club pursuant to this contract. Further, USATF/AAU, PVA and DC Speed reserve the right to prosecute should the circumstances warrant such an action.
• USATF/AAU, PVA and DC Speed do not allow smoking or consumption of alcoholic beverages, nor consumption/use of illegal drugs, at the track meets or track practices. I am agreeing to refrain from these behaviors as they are undesirable to the USATF/AAU, PVA and DC Speed and may result in my dismissal from the Club pursuant to this contract. Further, USATF/AAU, PVA and DC Speed reserve the right to prosecute should the circumstances warrant such an action.
By signing this Sportsmanship Contract and Liability W aiver below, I hereby acknowledge that I have read and discussed this document with all participating family members, including athletes, friends, volunteers, guests, etc. and pledge to be responsible for our words and actions while attending, coaching, officiating, volunteering, or otherwise participating in a DC Speed event AND FURTHER that I shall be responsible for ensuring that we conform our behavior to the Sportsmanship Contract and Liability Waiver.
I also agree not to hold the USATF/AAU, PVA, or DC Speed affiliates (i.e., coaches, officials, Board or League members, parents, staff, volunteers, athletes, children, or other attendees present at an event) responsible for the conduct of any person arising out of my failure to comply with these terms. The USATF/AAU, PVA and/or DC Speed shall incur no liability for full enforcement, limited enforcement and/or non-enforcement of this Sportsmanship Contract and Liability Waiver, as it does so at its sole discretion upon evaluating each circumstance and incident. Lastly, if any provision is determined unenforceable by law, all other provisions remain in effect and the illegal provision is stricken by itself.
Please sign, date and return with the registration materials.
Parent/Legal Guardian Signature: Date:
Parent/Legal Guardian Signature: Date:
DC SPEED TRACK CLUB
PARENT CODE OF CONDUCT
I hereby pledge to provide positive support, care and encouragement for my child participating in the DC Speed Track Program by following the Code of Ethics.
1. I will encourage good sportsmanship by demonstrating positive support for all athletes, coaches and officials at every meet, practice or other event.
2. I will place the emotional and physical well-being of my child and all DC Speed athletes ahead of my personal desire to win. I will do my very best to make track & field fun for my child.
3. I will provide support for coaches and officials working with my child to provide a positive, enjoyable experience.
I acknowledge that as a parent, I am required to stay outside the track area during meets and practices and allow the coaches to do their jobs.
4. I will insist that my child participate in a safe and healthy environment. I understand that no verbal or physical threats or abuse aimed at any coach, parent, athlete, participant, official or any other attendee will be tolerated.
5. I will insist that my child treat all athletes, coaches, parents, officials and opponents with respect regardless of race, creed, color, national origin, gender, sexual orientation or ability.
6. I will not use the internet, i.e., emailing, blogging, instant messaging) or electronic media: e.g., texting via cell phone, nor encourage my child or any other person to threaten or abuse any coach, parent, athlete, participant, or official.
7. I will pay all Club fees and dues in a timely manner.
8. I will present the Club with a copy of my child’s proof of age in a timely manner.
9. I will support and participate in all DC Speed fundraising efforts by working or soliciting for funds in whatever capacity that may be required. I understand that I will be charged and pay an additional opt-out fee if I choose not to participate in the fundraisers.
10. I will properly supervise my athlete(s) at all DC Speed functions that I attend. If I am unable to attend a function, I will ensure my child is being supervised by a designated responsible person.
11. I will support a drug, alcohol and tobacco free-sports environment for my child and agree to assist by refraining from their use at all sports events.
12. I will notify a coach in advance whenever my athlete(s) is not able to attend a track meet, or I agree to pay the required meet fee for each late-notification or no-show violation.
13. I will conduct myself in a peaceful and orderly fashion at all times during DC Speed events and refrain from using profanity, displaying disorderly conduct and/or inappropriate behavior.
14. I will be financially responsible for any items either broken, removed/stolen, or damaged in the hotel or on a bus either by me or my child(ren) while on a travel meet.
15. If I am unable to attend a meet, I will supply my athlete(s) with a lunch and/or sufficient amount of money for him/her to eat during the meet (at least $20.00).
16. Volunteering in some capacity is mandatory. Please see list of committees to determine where you would like to volunteer.
17. There is a separate policy for travel meets. I will adhere to the terms of the Travel Policy.
If you cannot abide by these rules, then please do not register for this Club.
I understand that failure to comply with any of the rules could result in temporary or permanent suspension from the Club.
Parent/Legal Guardian Signature: Date:
Parent/Legal Guardian Signature: Date:
DC SPEED TRACK CLUB
ATHLETE CODE OF CONDUCT
1. I will follow through with all practice routines and workouts as instructed.
2. I will attend all practices each week unless otherwise communicated and/or approved by a coach.
3. I will not engage in any other sport unless “approved” by a coach.
4. I will come prepared for practice (water, Gatorade, etc.) and wear proper attire during practice, (ex. running shoes (no basketball or canvas shoes), t-shirts, mid-thigh shorts and/or sweat pants, sweat shirts. No jeans/pants, skirts/shorts, or halter tops are allowed.
5. I understand that academics are the priority and that if my grades fall below a 2.0 GPA, I will seek assistance and/or tutoring to bring my GPA back up.
6. Upon arriving at meets, I will report to the group’s designated meeting place and stay until all instructions and warm-ups are completed. If I am hurt and not able to perform in one of my individual events, I understand that I will also likely not be allowed to participate in the relay if I’m on a relay team.
7. I will not leave the team area during a meet without first checking with an assigned adult and/or coach.
8. I will have respect and regard for fellow team members and opponents. I will exhibit sportsmanlike behavior at all times. I will respect and obey instructions given by any coach, parent or adult assigned to supervise the team. If I do not abide by these rules, I understand that I may be dismissed from the team, with or without a warning depending upon the severity of the offense. I understand that the Club may, as an alternative to dismissal from the team, either suspend me from practice/s, suspend me from meets, or suspend me for the remainder of the season.
9. I will always warm-up and stretch for 20 minutes before participating in each event.
10. I will be responsible for listening and reporting on time when my events are called.
11. I understand that relay participants may change each week and that if I am removed or added, I will willingly support the team wholeheartedly.
12. I will eat breakfast on meet days.
13. I will bring lunch and/or money for food/drinks to meets.
14. I will help clean up the team area before leaving at each meet.
15. I will support an alcohol and drug free environment. I understand that alcohol, tobacco and drug usage will result in an automatic expulsion from the DC Speed Track Club.
16. Vandalism, extortion, theft will not be tolerated. I will not take any items, including uniforms, warm- ups, or other personal property from anyone. I will turn in any unclaimed items found at practices or meets to a coach or board member for Lost and Found.
17. I will take responsible care of all equipment issued to me and will return such in good condition.
18. I will demonstrate good sportsmanship by having a positive attitude toward all of my teammates, coaches, officials and other youth at all meets, practice, or other youth sports events and applaud good play by both teams.
19. I will treat my teammates, coaches, parents, athletes and officials with respect regardless of race, gender, sexual orientation, creed, color, ability or any other factor of diversity.
If you cannot abide by these rules, then please do not register for this Club.
I understand that failure to comply with any of the rules could result in temporary or permanent suspension from the Club.
Athlete’s Signature: Date:
Athlete’s Signature: Date:
Athlete’s Signature: Date:
