Registrations for the Heritage Valley Blazers Youth Track and Field 2020 season is $115 for the first athlete, $105 for second and $95 for third and others. The Uniform is and additional $40 per athlete. If, last season uniform fits, then they do not need a new one. Registration is not complete until payment is made.

ATHLETE INFORMATION

* DENOTES A REQUIRED FIELD.

Gender *BoyGirl

Date of Birth *

Upload Birth Certificate*

PARENT/GUARDIAN INFORMATION

EMERGENCY CONTACT

MEDICAL INFORMATION

OTHER INFORMATION

List any/all conditions or limitations which may affect the athlete's ability to participate in this sport *

List all current medications (dosage) & allergies/reactions to medication *

EMERGENCY MEDICAL TREATMENT RELEASE

It is understood by me, the Parent(s)/Guardian(s) of the registered athlete, that in case of serious illness or accident, a reasonable effort will be made to contact me.
My spouse/guardian, or the emergency contact listed on this application form, will be contacted prior to any medical or dental care commenced, providing time and conditions permit. If, however, I or my spouse cannot be reached with reasonable diligence, or in the case of an immediate emergency, I hereby authorize the representative of the Heritage Valley Blazers Inc., the “Club”, to arrange for and to consent to such medical or dental care as may be recommended by a licensed physician or dentist. Such medical and/or dental care shall include, but is not limited to, routine diagnostic tests or examinations, including blood tests, radiographic or laboratory examinations, anesthesia, or any other treatment or care to be rendered under the general or specific supervision and upon the advice of a physician or surgeon licensed under the provisions of the Medical Practice Act or a dentist licensed under the Dental Practice Act. I further understand that this authorization is given in advance of any specific diagnosis, treatment or care. I agree to hold harmless the Club, its representatives, or any adult acting as an agent for the Club, from any liability arising out of the use of, or reliance, on this document. This authorization is given pursuant to the provisions of Section 25 of the Civil Code of the State of California. This authorization shall remain in effect until December 31, 2020 or no longer than one (1) year from the date of signing this form.

HVB CONDITIONS OF CLUB PARTICIPATION

PARENT(S)/GUARDIAN(S)/ATHLETE RESPONSIBILITES:
• Athletes will do their best to make every practice and be on time.
• Athletes will arrive to practice ready to listen, work hard and learn.
• Athletes will be supportive of all athletes on the Club teams.
• Athletes will show respect to all coaches, volunteers, teammates and opponents.
• Athletes will learn all rules and always compete by them.
• Athletes will use appropriate language only.
• Athletes will behave in appropriate conduct, actions to promote good sportsmanship.
• Athletes do not leave the premises of any track meet (even with parents(s) or guardian(s)) without informing coaches.
• Athletes will not be in possession of any drugs, alcohol or tobacco at any time.
• Athletes will compete in the designated Club uniforms only.
• Athletes will maintain at least a ‘C’ average throughout the school year.
• Parents, coaches, volunteers and friends of the Club must be role models for all athletes by conducting themselves as responsible, moral, ethical adults worthy of respect and emulation of children.
• Coaches will monitor attendance at practice and track meets, etc., to provide safety and protection for your children. Parents are to inform athlete(s)’ coach in advance if the athlete will not be able to participate in a practice or meet.
• Parents are responsible for providing transportation for their athlete(s) to and from practice/track meets, to insure safety and protection. Parents are responsible for getting their athlete(s) to practice and picking them up from practice on time. Coaches will NOT leave the premises of the track until ALL athletes are accounted for.
• Parents are not to remove their athlete(s) from the practice field or competition site without letting the appropriate coach know.
• Parents are not permitted on the track or practice areas during practice or track meets.
• Support coaches and volunteers.
• Parental interference with coaching will not be tolerated. Parents may discuss their athletes training/coaching program with their coaches following practice.
• Parents are to inform the coach of any special needs the athlete may have during the season as needed.
• Parents are required to volunteer at specified track meets and participate in fundraising events.
• Any complaints or disagreements regarding coaches or the Club shall be communicated to the President.
• Speaking ill of the Club and/or creating dissention among Club members and of other parents/guardians will not be tolerated.

HVB CLUB POLICIES

MEDIA POLICY
Athlete, parent and volunteers photos may be shown on Club Facebook page, Club website and or Club promotional material.
RETURNED CHECK POLICY
If, a check offered as payment(s) is returned by your financial institution for any reason, the Heritage Valley Blazers will impose a twenty-five dollar ($25.00) charge per instance and collection fees and/or costs.
REFUND POLICY
If, an athlete drops on or before February 29, 2020, the registration fee will be refunded less the uniform cost (if any issued). Athletes who drop after February 29, 2020, will forfeit their entire registration fee (up to $155 per athlete).
VOLUNTEER DEPOSIT POLICY
Parent or guardians are required to volunteer a certain number of hours per family. If, the certain number of hours are not met by end of season, then the volunteer deposit check, or credit card will get processed for the amount of $150. Turn in volunteer deposit check or credit card form to the Club treasurer, Francisco Velazquez.
BY CLICKING ON THE SUBMIT BUTTON BELOW I, THE PARENT/GUARDIAN, ACKNOWLEDGE TO HAVE READ AND AGREE TO THE EMERGENCY TREATMENT RELEASE, FOLLOW THE HVB CONDITIONS OF CLUB PARTICIPATION, ACCEPT THE HVB CLUB POLICIES AND GIVE PERMISSION FOR MY ATHLETE TO PARTICIPATE WITH THE HERITAGE VALLEY BLAZERS INC YOUTH TRACK CLUB.

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