Nativity CYO Track & Field | Forms - Nativity Catholic Church

Step 1 of 5

This field is hidden when viewing the form

Date

Player Information

Player's Name(Required)

First Last

School Grade for 2024-2025(Required)

CYO Sports is for students in grades 3 through 8.

Sex(Required)

Male

Female

Parent/Guardian Name(Required)

First Last

Parent/Guardian Email(Required)

Home Phone(Required)

Primary Phone(Required)

Secondary Phone

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Medical Release & Permission Form

Parental Permission and Liability Release
As parent/legal guardian of the participant named above, I give my permission to participate fully in Nativity CYO Track & Field (Name of Program or Trip) from March 16 (Start Date/Time) to May 17 (End Date/Time). I agree to indemnify and hereby release the Most Reverend Michael F. Burbidge of the Catholic Diocese of Arlington and his successors in office, as well as the Catholic Diocese of Arlington and all Diocesan clergy, employees, volunteers, and participating parishes and schools from any and all liability, claims, demands for personal injury, sickness and death, as well as property damage and expenses of any nature whatsoever which may be incurred by the undersigned of the participant resulting from said participant’s involvement in the above mentioned event (including transportation to and from the event). Furthermore, I on behalf of the participant hereby assume all risk of personal injury, sickness, death, damage, and expenses resulting from said participant’s involvement in the above-described event.

Informed Consent to Medical Treatment
I request that in my absence the above-named minor be admitted to any hospital or medical facility for diagnosis and treatment when a condition or injury arises that is serious enough that a reasonable person would seek care right away. I request and authorize physicians, dentists, and staff, duly licensed as Doctors of Medicine or Doctors of Dentistry or other such licensed technicians or nurses, to perform any diagnostic procedures, treatment procedures, operative procedures and x-ray treatment of the above minor. I have not been given a guarantee as to the results of examination or treatment. I authorize the hospital or medical facility to dispose of any specimen or tissue taken from the above-named minor. I assume full responsibility for all costs of such treatment. Further, should it be necessary for the participant to return home due to medical, disciplinary, or other reasons, I do hereby assume responsibility for the participant’s transportation home and any costs related thereto.

Photo, Press, Audio, and Electronic Media Release
I authorize the Catholic Diocese of Arlington, its parishes, its schools and/or the Arlington Catholic Herald to use and publish my child’s photograph, video and/or audio recording along with their name identifying them for educational, news stories, illustration and/or marketing purposes.

I understand and hereby agree to the terms and conditions of the participant’s involvement in the above-described event, and I freely execute this Acknowledgement with full knowledge of its content.

Signature of Parent/Guardian(Required)

Signature of (Youth) Particpant(Required)

Health Information

Primary Health Provider(Required)

Health Provider Phone(Required)

Insurance Company(Required)

Insurance Policy Number(Required)

Check box if youth participant is not currently insured

Not currently insured

List any medical conditions that may affect the participant’s involvement in this program:

List any allergies:

Emergency Contact Information

Emergency Contact Name(Required)

First Last

Relationship to youth participant?(Required)

Emergency's Primary Phone(Required)

Emergency's Secondary Phone(Required)

Code of Conduct

CODE OF CONDUCT FOR ALL PARTICIPANTS

As I consider my participation in NVJCYO, I am asked to reflect on the letters “C” and “Y” in the acronym—and how Catholic youth sports must be different. Each time a youth takes the field, court, track or other venue it can be an incredibly productive event. Whether it actually is productive depends on me…
… me, as an athlete, challenging myself to use all the gifts given by the Lord, the coach, and those who care for me. … me, as a coach or spectator, remembering that the game or activity should be about long-term formation in every sense of the word—physical, mental, social and spiritual. What is at stake is nothing less than the mental and spiritual well-being of those who hear my words and see my actions. If I am to set an example at all, I pray it will be a good one.

What I Expect of Myself and Others Expect of Me (All Athletes, Coaches, Spectators must acknowledge and agree to terms in order to participate)

When my parish hosts, I will welcome parents/players of the other team as we prepare for friendly competition.
I will represent our parish well by displaying excellent behavior, by being courteous and never using inappropriate language or taunting opponents or teammates or others in games or practices.
I will cheer my team and applaud the efforts of all, never engaging in negative or unsportsmanlike cheering.
I will be reverent and respectful when teams are in prayer.
I will demonstrate good sportsmanship & sincerely congratulate the other team’s effort.
I will remain quiet during free throws.
I will respect rules established by the league, such as no food or drink or smoking in the gyms and will cooperate in a courteous way with volunteers who are asked to enforce those rules.
I will not engage in inappropriate physical contact, fighting or inappropriate verbal exchanges.
I will not approach or engage with any official, timekeeper, or scorekeeper in a confrontational or sarcastic manner.
I will respect the judgment of officials and abide by the rules of the contest and the facility. Mistakes happen; viewing angles and perspectives are different. I will demonstrate forgiveness, understanding and respect by not disputing the judgment of the officials who were selected to make those calls. If I feel my child’s safety is at risk I then have the obligation to ask the coach to remove him/her from the game.
I understand that no code of conduct can cover all circumstances and expectations and that team, parish, league or diocesan officials have discretion in evaluating behavior and providing correction. Further, I understand that these officials have an affirmative responsibility to those around me and impressionable youth to take disciplinary action, which may include but not be limited to relinquishment of my privileges to participate in parish/NVJCYO activities and/or forfeiture of games by my parish’s team.

Additionally for Spectators, Parents, Guardians…

I will respect the coaches’ time and effort and will leave the coaching to them during the games, and focus on how I can make the most of my role in encouraging my player.
I understand that it is my responsibility as the parent or guardian to ensure that I do not leave my youth at an activity until there are 2 appropriate adults to chaperone him/her.
I will remain in the bleachers/on the sideline and never enter the field of play or court; I will also stay off the playing surface after the game and will not congregate in the foyers so that the next teams may warm-up and proper egress is maintained.
I will not allow those under my care to roam free, especially under the bleachers, in the hallways, foyers, restrooms, on the stages, on parish grounds or in parking lots.

Additionally for Coaches…

When interacting with the officials, I will remember that all eyes and ears are on me as a role model and I will interact with respect and humility.

Nativity CYO Track & Field | Forms

Player Information

Medical Release & Permission Form

Health Information

Emergency Contact Information

Code of Conduct

Concussion Fact Sheet

Registration Fee