Fee to play football (ages 7-14) $ (This covers team fees, equipment, equipment repair, field usage, etc,)

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1 Dates and Times are subject to change with prior notice Bruins Football 2018 Practice Schedule Welcome to the Bruins Jr. All American Football and Cheer Program. Monday, July 30 th is the first night of practice. Make sure you have your contract and physical turned in or your child will not be allowed to practice until received. All fees are to be paid in full on meet the staff day (July 30) or your child will not be allowed to practice and will be in jeopardy of losing their reserved spot on the team. Fee to play football (ages 7-14) $ (This covers team fees, equipment, equipment repair, field usage, etc,) Fee to play football (ages5-6) $150 (This covers team fees, equipment, equipment repair, field usage, etc,) Two mandatory league fundraiser for all players $170 $150 Raffle tickets (2) Applebee s breakfast tickets ($10 each) date to be announced Players receive spirit pack which includes basic picture packet, trophy, and game jersey at the end of the season. (Must remain active in order to receive the following items listed above, but are not limited too.) PRACTICE SCHEDULE AND UPCOMING EVENTS July 29 th July 30 th Aug. 11 th Aug. 25 th Sept. - throughout Sept. 8 th Sept. 17 th Mandatory sports participation our practice field $20.00 cash only (football and cheerleaders) Meet the staff/parent meeting/ raffle drawing All Final Payments are Due (No Exceptions) Equipment Handout-helmets and shoulder pads (player must be paid in full to receive gear) First day of practice Mandatory Conference football clinic (time and location TBD) $15 per player Mandatory Mass Weigh In (time and location TBD) Practice Tuesday and Thursday 6pm-8pm (All Games are on Saturdays) First game of the season (time and location TBD) Picture Day 4:00pm (practice field) Things that are not covered that you will need to provide for your player prior to the start of the season All sport cleats molded-no metal or Mouthpiece with strap- no red, orange removal spikes. (no screw offs) or clear Athletic cup- soft or hard (players Chin strap for helmet choice) Practice jersey or large T-shirt to fit Girdle with hip and tail pad slots over shoulder pads (limited jerseys avail for sale) Practice pants any color All fees must be paid in full before any gear is issued. Parents SignatureChilds s Name_ www. Bruinsfbncheer.com President A. Steele

2 YOUTH TACKLE CONFERENCE OF THE INLAND EMPIRE, INC. DBA INLAND EMPIRE JUNIOR ALL AMERICAN CONFERENCE, INC PLAYER'S SEASON CONTRACT (PLEASE READ CAREFULLY) SECTION I (Chapter Officials WILL complete SECTION I AFTER candidate has been assigned a specific Team, League and Division) Rev. 2/16 RM IEJAAFC CHAPTER: BLOOMINGTON TEAM NAME/ MASCOT: BRUINS PARTICIPATION (circle one): CHEER FOOTBALL STATUS (circle one): NEW WAIVER DIVISION (circle one): MASCOT FLAG D-LEAGUE JR. MICRO MICRO JR. PEEWEE PEEWEE JR. MIDGET MIDGET SECTION II TO BE COMPLETED BY CANDIDATE PLAYER & PARENTS NO CANDIDATE will be permitted to participate in any activity until SECTIONS 11, III, V and VI of this Contract has been completed in full. The CANDIDATE PLAYER agrees that he will faithfully abide by the Rules of the IEJAAFC to the very best of his ability. ast Name First Middle Birth Date Age as of July 31 st School & grade Address City Zip Home phone number Cell number Parent/Guardian Cell number Parent/Guardian SECTION III EQUIPMENT RESPONSIBILITY I/We as parent/guardian of said candidate do hereby assume full and complete for the proper care and maintenance of all equipment loaned by Local Chapter to said candidate. I understand all equipment is to be used for IEJAAFC activities only and that all equipment remains the legal property of Local Chapter. I agree to reimburse Local Chapter for any and all equipment that is lost, damaged or stolen for the full replacement cost of said equipment, with payment due when equipment is requested by Local Chapter, or immediately upon the withdrawal of said candidate from Local Chapter. RULES AND REGULATION I/We as parent/guardian of said candidate understand it is the responsibility of the parent/guardian, candidate, team and chapter to comply with any and all rules and regulations of IEJAAFC. Any noncompliance with rules and regulations shall be cause for disciplinary action to be taken against said candidate, parent/guardian, team or chapter by IEJAAFC. PARENT/GUARDIAN: Signature Print Name Date RELATIONSHIP TO MINOR: FATHER MOTHER LEGAL GUARDIAN SECTION IV PROOF OF AGE (to be completed by Athletic Director) FULL Legal Name: (No Nicknames) (Please print) Birth date (Month, Day, Year) Proof of Age: Birth Cert Abstract Gov t ID Record of foreign birth SECTION V REMARKS: MEDICAL EXAMINATION (BY QUALIFIED DOCTOR OF MEDICINE) (NO CHIROPRACTOR) (Doctors stamped required in this section with name of Doctor, address & phone for this portion to be VALID) Height_ Weight Blood Pr. Heart Ears Nose Teeth Abdomen Extremities While this examination does not constitute a complete Medical Examination, it does on this date, and based upon my observation, meet the requirement for participation in this youth football program. Individual examined by me this date is considered not physically qualified to participate in this youth football program for the following reasons: Examining Dr. Office Phone Date SECTION IV FOR RESPONSIBLE CHAPTER AND TEAM OFFICIALS ONLY In approving the above Candidate's Player Season Contract, we hereby certify that the Birth Certificate submitted does correspond with the name and birth date shown in Sections 11 and Ill. In addition, we hereby certify that the Parental Consent and Medical Treatment Authorizations, Section Ill, was completed, and, together with the Medical Examination, Section IV, was completed by the qualified Doctor of Medicine listed, prior to the Candidate's participation in any manner with this team. We certify that we have explained fully the procedures to follow in the event of injury, and that in- jury/insurance reporting must be performed in accordance with IEJAAFC rules and procedures. Finally, we certify that a copy of the Player Season Contract was furnished to the Parent(s) or Guardian, as applicable. Responsible Chapter Official Date Signed Certification Official Date Signed (Must sign in red pen only) (Red pen only)

3 ABOUT THE CONFERENCE/LEAGUE INSURANCE COVERAGE SECTION VI. PARENTAL CONSENT PERMISSION TO PARTICIPATE INITIAL: I/We the parents/guardians of the minor named in Section II Candidate for a position on the IEJAAFC Team, hereby give my/our approval to his/her participation in any and all IEJAAFC activities during the current season. I/We acknowledge the potential dangers of participation in any sport and fully understand that participation in football and /or cheerleading may result in SERIOUS INJURIES, PARALYSIS, PERMANENT DISABILITY AND/OR DEATH. I/We assume all risks and hazards incidental to such participation, including transportation to and from such activities. I/We do hereby waive, release, absolve, indemnify, and agree to hold harmless the team, the Chapter, and the IEJAAFC including sponsors and other related participants, for any injury to my/our child. IEJAAFC has advertising, modeling and photo copyrights. SCHOLASTIC FITNESS INITIAL: I am of the opinion that my son/daughter/ward is scholastically fit and would benefit by participation in this program. I agree to submit a copy of my son/daughter/ward s last completed grade, end of year/last complete report card or a written statement of scholastic fitness from the school administration. HELMET WAIVER (FOR FOOTBALL PARTICIPANTS) PLAYER INITIAL: PARENT/GUARDIAN INITIAL: I/We acknowledge, AND I/We understand the risks involved in my CHILD/WARD, playing football, which is a collision sport; the NOCSAE committee has adopted the following warning to be read by, and signed by, both the parent/guardian and participant. DO NOT USE THIS HELMET TO BUTT, RAM OR SPEAR AN OPPOSING PLAYER. THIS IS IN VIOLATION OF FOOTBALL RULES AND CAN RESULT IN SEVERE HEAD, BRAIN OR NECK INJURY, PARALYSIS OR DEATH AND POSSIBLE INJURY TO YOUR OPPONENT. THERE IS A RISK THAT THESE INJURIES MAY ALSO OCCUR AS A RESULT OF AN ACCIDENTAL CONTACT WITHOUT INTENT TO BUTT, RAM OR SPEAR. NO HELMET CAN PREVENT ALL SUCH INJURIES. MEDICAL TREATMENT AUTHORIZATION INITIAL: The IEJAAFC has Secondary Excess Accident-Medical Group Insurance coverage, with a deductible amount for each injury incurred. The IEJAAFC group insurance is "SECONDARY EXCESS COVERAGE," over any valid collectable coverage provided by the parent's separate personal or employee's dependent group insurance. The IEJAAFC secondary group covers one year from date of first treatment, for each injury, with dental coverage, for sound natural teeth, including dental X-rays. Abdominal hernia and pre-existing conditions are excluded. In executing the foregoing release, I/we, the under- signed acknowledge and represent that I/we understand that any claim for injuries which arises out of our child's participation, must be reported to the Team or Chapter Officials "IMMEDIATELY". The insurance claim form must be filled out and delivered to the Conference Insurance Commissioner WITHIN 30 DAYS from the date of injury. I/We have read the foregoing release, understand it and signed it voluntarily. THE NAME OF OUR OWN AND/OR EMPLOYMENT GROUP INSURANCE COMPANY IS: POLICY NUMBER: (IF NO INSURANCE, List Father's or Mother s Soc. Security No.) In the event of injury to MY/OUR Child, I/We hereby grant authority to a qualified Doctor of Medicine to render such medical treatment as said Doctor of Medicine deems necessary under the circumstances. PLEASE LIST ALL ALLERGIES: A. IMPORTANT NOTICE (State required Disclosure statement; C.I.C. Section ) THIS IS AN EXCESS PLAN The Medical Expense Benefit of this Plan (Program) is an EXCESS type benefit that picks up where other coverage leaves off. If you have any other individual, franchise, blanket or group (except automobile medical payments insurance) coverage which provides benefits of services for, or by reason of, medical or dental care or treatment, then this Plan (Program) will pay ONLY the medical expenses not provided or reimbursable under your other coverage. The premium for this Plan (Program) has been reduced, taking this into account. If you have any other coverage, you should first submit you claim under that coverage. You should submit a claim under this Plan (Program) only if you have no other coverage or if your other coverage does not fully provide or pay for your medical care or treatment. Failure to submit the claim to your primary carrier can result in delaying payment by IEJAAFC insurance carrier. B. The Conference/League insurance is EXCESS only. This means that the Parents/Guardians OWN INSURANCE MUST BE NOTIFIED OF THE INJURY. If the Parents/Guardians have insurance WITH PRE-PAID MEDICAL PLANS, such as Kaiser, the injured person MUST BE TAKEN TO THE PRE-PAID MEDICAL FACILITIES, for treatment. C. If insured s Parent s/guardians HAVE NO OTHER 1 st OR PRIMARY INSURANCE; the Conference/League group insurance may be used. BUT THERE IS A $ DEDUCTIBLE FOR EACH INJURY. D. The Conference/League group insurance PAYS ONLY TO THE HOSPITALS AND DOCTORS unless receipts are submitted showing proof of payment by Parent/Guardian to the Hospital/Medical Treatment center. The following forms are required to process the claim. 1. Insurance Claim Form. 2. Chapter AD report of injury. 3. Copy of Parent/Guardian Insurance card. 4. Hippa Form. 5. Copy of any medical bills. 6. Copy of player s contract. E. Any and all claims MUST be reported to your Chapter AD. The Chapter AD will then notify IEJAAFC. PRINT PARENT/GUARDIAN NAME PARENT/GUARDIAN SIGNATURE DATE Rev. 02/16 RM

4 YOUTH TACKLE CONFERENCE OF THE INLAND EMPIRE, INC. 20 Members Code of Conduct In accordance with the Inland Empire Junior All American Football Conference (IEJAAFC) each participating member and parent must sign this Member Code of Conduct before being certified for participation. I/We as a member of the Bruins football and cheer program agree to adhere to the following: I/We will not for any reason go on to the football field during practice and/or games unless summoned by the Head Coach or Team Athletic Director. I/We will not use profanity, tobacco products or alcoholic beverages at any practice or game field in accordance with the IEJAAFC Conference rulebook. Violation of this rule can result in suspension from the league for my family including my child. I/We will not approach or berate any game officials, league officials and/or conference board members. Violation of this rule can result in suspension from the league for my family including my child. I/We agree to abide by the 24-hour cool down period prior to discussing concerns with my child s coaches after a game. I/We understand that fighting is not tolerated and will result in immediate suspension or termination from the league. I/We agree that the Bruins football and cheer program is for the kids and should be free of adult ambition. Local Authorities will be contacted and apprised of any threats of physical harm against children or adults, which can lead to arrest and/or prosecution. The Inland Empire Junior All American Football Conference (IEJAAFC) has adopted a zero tolerance rule in handling behavior issues for this season. Any participant in IEJAAFC can be banned from participation in football or cheer if they or their parents/guardians demonstrate any disruptive behavior. Both the football player and parent/legal guardian prior to participation in an IEJAAFC football game must sign this document. Player Signature Parent Signature Date_ Team Division

5 Bruins Participants Season Rules Please read all rules governing the Bruins Football and Cheer program. Participation is a privilege and it contingent upon you, your child and any of your guests following the rules. Please review all the rules with your child to ensure a pleasurable experience for all. Please initial each line after reading it carefully, and you and your child please sign and date the bottom of the form. A copy of these rules will be available for your review. _ All adults MUST conduct themselves in mature manner. Absolutely NO ALCOHOL OR ILLEGAL SUBSTANCES are allowed anywhere by anyone at practices, game field or events. No profanity or racial remarks will be permitted at any time. Player or parents may not display gang color or gang apparel at anytime on are near our game, practice field or events. Absolutely NO BANDANAS. No one is allowed on the practice field unless they are a coach, staff member, player or board member except in the areas designated for spectators. Players, parents and visitors you invite must respect and obey ALL staff members and rules. Any player that disrupts practices or refuse to participate will be required to have their parents in attendance before they are allowed to practice again. Players must maintain at least a 2.0 grade point avera. (i.e. C avg.) Two unexcused absences will constitute dismissal from the team. Please call your coach, AD, team mom or other staff, if your child cannot make practice. Coaches will conscientiously attempt to play every player a minimum of Five (5) plays in each scheduled game. Each player shall be afforded the maximum opportunity to participate in each game consistent with his/her abilities, desire to play and strategy of the game plus consideration of practice, attendance and physical status. 1

6 Players will not criticize the opposing team, their coaches, or their fans, by words or gestures. Football players shall remain with their coaching staff for the entire game or practice. A Medical Doctor release is required before any player can return to practices or game after any injury that is reported that happened on or off the field. All players must have a Medical Physical done on the Conference Contract before starting practices in July. (Physical must be dated after May and stamped by your doctor) Parents or spectators are not allowed to interrupt practices or games expecting to talk with the coaching staff. All concerns MUST be addressed to the team AD, who will approach the staff in the event of a concern requiring immediate attention. All conversation with the coaching staff is to be reserved for after practices and games or at the coaches discretion. Players should use their break time for the restroom and water. Player registration fee and refund policy will be as follows: There are no refunds of registration fees, fundraiser money raised or donated, sponsorship money received on your behalf. You are only entitled to your equipment deposit if one was received. At least one parent at practices and games at all times. All players must be photographed for Conference ID Cards. All players must show proof of residence at the time of sign up by bringing a copy of a current utility bill (This copy we will keep) On game days there is a 24 hr. cooling off period before you can address your staff with matters of the games. 2

7 As Parent/Guardian, you are responsible for your behavior as well as the behavior of other individuals who have come to watch your child or child under your guardianship participate in our program. Additionally, local authorities will be notified of all threats, whether physical or verbal, made against children, adults, chapter officials, or referees which can lead to arrest and prosecution. Safety and the protection of all is our number one concern. By signing this you agree to the stands as set forth by the conference of Inland Empire Jr. All American Football and Cheer. Your signature below indicates that you ans your child agree to observe the rules Governing the Bruins Football Season Football Player: Date: Parent Name: Parent Signature:_ Cell#_ If you have any questions or suggestions fell free to contact the fooball staff. We Hope you and your football player will enjoy this season. We welcome your and Your family to the Bruins Football Programs. CHAPTER PRESIDENT ANTHONY STEELE

8 INLAND EMPIRE JUNIOR ALL AMERICAN FOOTBALL CONFERENCE PLAYER AND CHEERLEADER INFORMATION FORM CHAPTER USE ONLY Returning Player/Cheerleader: YES/NO If yes where? FOOTBALL CHEERLEADER DIVISION: Mascots, Jr. Micro, Micro, Jr.Pee Wee, Pee Wee, Midgets Weight_ (Cheer only) (Football Only) TO BE COMPLETED BY PLAYERS PARENTS/GUARDIAN Player's Last Name, First Name Middle Initial / / Birthdate Age on July 31st Address City Zip Code Home Phone Parent/Guardian (Print) Parent/Guardian (Print) (Home Number) (Cell Number) (Home Number) (Cell Number) ADDRESS (Main source for communicating updates ) EMERGENCY CONTACTS Name Address Phone Number Name Address Phone Number Name Address Phone Number MEDICAL CONSENT *In the event of an injury to MY/OUR child, I/WE hereby grant authority to a qualified Doctor of Medicine to render such medical treatment as said Doctor. Parent/Guardian (Signature) Parent/Guardian (Signature) INSURANCE INFORMATION Insurance Company_ Insurance Number (List Parents Social Security Number if there is no coverage) Please List ALL ALERGIES: information form x VS 1/09

SOUTHERN CALIFORNIA JUNIOR ALL AMERICAN CONFERENCE, INC PLAYER'S SEASON CONTRACT (PLEASE READ CAREFULLY) Rev. 1/16

SOUTHERN CALIFORNIA JUNIOR ALL AMERICAN CONFERENCE, INC. 2019 PLAYER'S SEASON CONTRACT (PLEASE READ CAREFULLY) Rev. 1/16 SECTION I SCJAAFC Chapter Apple Valley Team Name Rebels CHECK STATUS NEW RETURNING