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Park Orchards North Ringwood Parish Junior Football Club
REGISTRATION APPLICATION 2015
FAMILY DETAILS
MOTHER/GUARDIAN
Surname
Address
Suburb
Postcode
Phone (AH)
First name
Surname
Occupation
Mobile
Email
PLAYER 1
Returning
FATHER/GUARDIAN
First name
Surname
Occupation
Mobile
Email
PLAYER 2
New
Returning
FootyWeb No
First name
Surname
Date of birth
Turning in 2015
School
Prior Team
PLAYER 3
New
FootyWeb No
First name
Surname
Date of birth
Turning in 2015
School
Prior Team
Returning
New
FootyWeb No
First name
Surname
Date of birth
Turning in 2015
School
Prior Team
PAYMENT DETAILS
Teams (1)
No. Players
Fee
Amount
Tackers – Under 15
$170
$
Colts (Under 16 -17)
$195
$
Less: Family Discount (2)
Less each additional $10
$
Add: Donation to Sharks
$
TOTAL (3)
$
NOTES
1. Players will be placed in teams based on their date of birth, with considerations given to written applications to the Director of Football
seeking to play in an alternative age group. Approval will be dependent on YJFL Rules, team numbers and our Teams Selection Policy.
2. Family discount applies when there are two or more players in the family, e.g. 2 players are entitled to $20 discount, 3 to $30 etc
3. Players are not eligible for team selection, or a club bonus, until all registration fees are paid
Cheques made payable to PONRPJFC Inc for full payment can be mailed with this form to the Registrar – address below
Credit card
Exp. date:
Mastercard
/
Name on card:
X
Access code:
X
Visa
for total being paid
Card no.
Cash for total being paid. Applies to Registration Day Only - Team Managers or Coaches will NOT receive cash payments
TO COMPLETE REGISTRATION FOR 2015
Returning players:



Complete Registration Application. Tick Returning Player.
Complete Consent and Medical Details -for each player - attached
Make Registration Payment
Office
Use
Only
New Players:
 Complete Registration Application. Tick New Player.
 Complete Consent and Medical Details -for each player - attached



Must provide a copy of birth certificate or other proof of age
Make Registration Payment
Complete and sign YJFL Registration/Transfer Form
(J)
Date paid (dd/mm):
Method:
/
Cheque / Credit Card / Cash
Receipt No:
Complete and post these forms with your payment to Sharks Registrar Sharks Registrar – PO Box 2281 North Ringwood Victoria 3134
Version 2015
Park Orchards North Ringwood Parish Junior Football Club
CONSENT AND CODE OF CONDUCT 2015
This form is to be completed and posted to the club at PO Box 2281 North Ringwood 3134
OR
Submitted to the Team Manager at the commencement of the season before a player is considered eligible to play
PLAYERS DETAILS
First name
Surname
DOB
Phone (AH)
MOTHER/GUARDIAN
First name
Surname
Occupation
Mobile
FATHER/GUARDIAN
First name
Surname
Occupation
Mobile
RETURNING PLAYERS ONLY
Online Registration Member No.
Registration Receipt No.
VOLUNTEERS
Park Orchards North Ringwood Parish Junior Football Club is a junior sporting organisation that relies upon volunteers at all levels to help
create a successful and well run club for players and their families. We are constantly in need of volunteers and would appreciate an indication
of where you might be able to assist.
Coach
Team Manager
Trainer
Committee role
Other (specify)
PHOTOS
From time to time the Park Orchards North Ringwood Parish Junior Football Club may use images of players, officials and parents for
promotional purposes. Completion of this form acknowledges you have read and agreed to this use.
Parent/guardian signature:
Date:
FEES and LEVIES
The Park Orchards North Ringwood Parish Junior Football Club makes available football jumpers for use by registered players, but these remain
the property of the club. A $150 fee will be levied for jumpers not returned when requested. Completion of this form acknowledges you have
read and agreed to these fees and levies.
Parent/guardian signature:
Date:
CODE OF CONDUCT
You will find attached to this Registration Form the Yarra Junior Football League Code of Conduct. It is extremely important, for the good of the
club that all club members understand and adhere to the guidelines of the Code of Conduct.
I hereby acknowledge that I have read and understood the enclosed Yarra Junior Football League Code of Conduct and agree to abide by these
rules.
Parent/guardian signature:
Date:
Player/s signature:
Date:
Please refer to the Park Orchards North Ringwood Parish Junior Football Club webpage - http://www.sharksjfc.org.au/ - for our internal policies.
Version 2015
YARRA JUNIOR FOOTBALL LEAGUE
CODES OF CONDUCT
Coaches
1. Abide by the Laws of the Game, Club Rules and League Rules
2. Teach the Rules: Rules are mutual agreements which nobody should break
3. Group players competitively
4. Avoid overplaying talented players
5. Maximise fun: Place winning in perspective
6. Stress safety always
7. Consider maturity levels: Devise training programs to suit all
8. Develop team respect: For opponents , umpires and coaches
9. Recognise the importance of proper injury treatment
10. Keep up to date with Coaching developments
11. Attain Coaching accreditation
12. Avoid derogatory language based on gender or race
13. Shall not engage in the aggressive recruitment of players. (Aggressive recruitment is to be determined on the facts of each particular
case. As a guide only, aggressive recruitment will be considered to have occurred where there is contact on more than one occasion with
a player (parent/guardian) and/or inducement is offered to a player to change Clubs).
Players
1. Play by the laws and rules
2. Don’t argue
3. Control your temper
4. Be a team player
5. Be a good sport
6. Treat all players fairly
7. Cooperate with your coach and teammates
8. Play for fun and improvement
9. Avoid ugly remarks based on race or gender
Parents
1. Encourage participation but do not force them
2. Teach that honest effort is the victory, not the winning
3. Encourage to play by the rules
4. Never ridicule mistakes or losses
5. Remember, involvement is for their enjoyment, not yours
6. Remember, they learn best by example. Applaud both teams
7. Recognise positively the recreational contribution of voluntary officials
8. Never publicly disagree with officials. Raise issues privately
9. Support all efforts to remove verbal, racial and physical abuse
10. Support your club officials to foster high standards of behaviour for your Club/League
Version 2015
Park Orchards North Ringwood Parish Junior Football Club
MEDICAL FORM 2015
PLAYERS DETAILS
MOTHER/GUARDIAN
First name
Surname
Occupation
Mobile
Email
First name
Surname
DOB
Postcode
Phone (AH)
FATHER/GUARDIAN
First name
Surname
Occupation
Mobile
Email
DETAILS
HEALTH PRACTITIONERS
Family Doctor:
Address:
Family Dentist:
Address:
Phone:
After hours:
Phone:
After hours:
FUNDS
Medicare No.
Private Health Fund:
Card No:
Member No:
CONDITIONS – Does your child suffer from? (please check box)
Heart Condition
Dizzy Spells
Diabetes
Blackouts
Food Allergies
Medication Allergies
Special needs (please specify):
Fits of any kind
Asthma
Migraines
Other needs (please specify):
INSURANCE
The Park Orchards North Ringwood Parish Junior Football Club strongly recommends that all Players, Coaches, and Team Officials
who participate in training and match day duties, be members of a Medical Benefit Association, and be covered by insurance for
their own protection. The Park Orchards North Ringwood Parish Junior Football Club does not cover any medical expenses or any
costs due to insurance gaps, however limited insurance cover is provided through our cover with JLT Sport and the YJFL. This may
be of some benefit to you in the event of an injury sustained whilst performing your duties at training or on match days.
It is hereby acknowledged that the Park Orchards North Ringwood Parish Junior Football Club Inc. is not in any way responsible
for any liability or expense whatsoever and that we will make no claim against the club or its members as a result of any injury to
playing members while participating in any activity nominated by the club.
Parent/guardian signature:
Date:
ACKNOWLEDGEMENT and AUTHORISATION
To the best of my knowledge, all information contained on this form is correct. I authorise Park Orchards North Ringwood Parish
Junior Football Club Inc. to provide first-aid and consent, where it is impractical to communicate with either the Emergency
Contact or person in whose care the player has been placed for the day (e.g. at the game), to the player receiving medical or
surgical treatment as may be deemed necessary.
Parent/guardian signature:
Date:
Office
Use
Only
(J)
Date received (dd/mm):
/
Method:
Transferred to Team Manager:
Note any corrections on this page and post these forms with your payment to Sharks Registrar – PO Box 2281 North Ringwood Victoria 3134
Version 2015