Team Nomination Form for Social Sports
Section 1: Social Sport Selection
Floorball Basketball Indoor Soccer Netball Ladies Morning Netball
Section 2: Team Name and Contact
Team Name ______
Primary Contact Name ______
Contact Numbers ______(HM) ______(MB)
Email ______
Secondary Contact Name ______
Contact Numbers ______(HM) ______(MB)
Email ______
Section 3: Your players Details
Full Name Email Mobile Phone 1. 2. 3. 4. 5. 6. 7. 8. 9.
The Shire of Northam requests that each Team Sports team must provide/nominate an umpire for games. * Failure to provide an umpire with no notice will incur a 2 point deduction in the league. Nominated Umpire: ______
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Section 4: Other details
Shirt Colour ______
Shorts Colour ______
Section 5: Cost
Each player per game pays $7 Floorball Stick Hire $2 Forfeit Fee: $29
Section 6: Sports
Floorball: Must have a minimum 2 females on court at any time. 2 x 20min halves and 5 min half time Basketball: No more than 3 players of the same gender on the court at any time. Indoor Soccer: 5 players on the court, 1 must be female. 2 x 15 min halves. Mixed Netball: Maximum of 3 males on the court at any time. 4 x 10min quarters *Please Note*- males and females under 16’s are considered “females” and are eligible to play as a part of the minimum female numbers. Please sign the under 16’s consent form.
I, ______declare that, as team captain, I will be responsible to ensure that all players who represent this team name will, for the duration of the season, including any finals, honour all forfeit fees, surcharges and suspensions that may be imposed on the team by the competition officials of the Shire of Northam. We, as a member of this team, declare that on signing this form accept the competitions fees and charges are subject to change and may increase as per the annual review. We acknowledge and declare that the team participants will conduct their behaviour in accordance with Shire of Northam code of conduct and accept any penalties incurred for violating these standards. We also declare that we understand that taking part in any competition may expose a team member to the possible risk of injury and that the Shire of Northam is not liable for any injury, damages or costs incurred by players as a result of an injury of any nature suffered during the course of play in the competition or in respect to that occurring on the Recreation Centre and its grounds, except to the extent of negligence by the Shire of Northam and indemnify the Shire and its employees in respect thereof. We understand that by playing with an existing injury or pregnancy we may put your bodies at further risk. All players play at their own risk.
Staff Use Only
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Code of Conduct received YES/NO Date:______
Northam Recreation Centre
Code of Conduct
All Northam Recreation Centre programs are designed to be played as social competitions. These sports are designed for the enjoyment of all people and we need to provide a safe, friendly and non-threatening environment to participate in these programs. Following is a code of conduct all teams, players and spectators must abide by to participate in these programs.
Umpires
1a) All players, spectators and officials must show respect towards umpires. Intimidating behaviour or disrespect towards umpires will not be tolerated and may result in the offending person being ejected from the program.
1b) If a player or team has a dispute or question regarding umpiring decisions, the team captain can address these with the umpires at half time or after the game. Players must show respect towards the umpires and deal with these issues in a calm and non-threatening manner.
1c) If a player or team is not satisfied with the responses of the umpire or centre staff the issue can be referred to the Recreation Services Manager.
2 Staff
2a) All players, spectators and officials must show respect towards recreation staff. Intimidating behaviour or disrespect towards staff will not
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be tolerated and may result in the offending person being ejected from the program
3 Swearing
3a) Swearing will not be tolerated from players, spectators or officials. Audible swearing whilst on the field will result in a warning to the offending person. A second swearing offence during the same game will result in a send off of the offending player.
3b) Any player who swears at an opposition player, umpire or spectator to cause intimidation to that person will be immediately expelled from the program.
3c) It is the team captain’s responsibility to make sure all players and spectators affiliated with their team do not swear at officials, players or spectators. Repeated offences may result in the player or team being removed from the competition.
4 Violence
4a) Any player, team or spectator involved in a violent act either, before, during or after a game will result in that player being suspended from the competition. Any attack, be it verbal, physical or threatening behaviour will be considered a violent act. The umpires and Recreation Services Manager will determine the length of the suspension for the offending player.
4b) Repeated incidence of any threatening or violent behaviour will result in the player, and/or team being removed from the competition. Violent acts are deemed very serious and may result in permanent ban from participation in Recreation Centre programs. The umpires and centre management will determine the length of the suspension for the offending player/s.
4c) Any player suspended from a competition because of a violent act will not be able to enter the Recreation Centre until the suspension has been served.
4d) It is the team captain’s responsibility to make sure all players and spectators affiliated with their team do not act in a violent or threatening manner. Repeated offences may result in the player or team being removed from the competition.
5 Sportsmanship
5a) All player, spectators and persons affiliated to a particular team will conduct themselves in the appropriate manner and show a high level of sportsmanship towards team-mates, opponents, spectators and officials.
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5b) Examples of unsportsmanlike behaviour are, throwing the ball away at stop of play, disputing decisions, overly rough play etc.
5c) It is the team captain’s responsibility to make sure all players and spectators affiliated with their team act in a sportsman like manner. Repeated offences may result in the player or team being removed from the competition.
6 Alcohol
6a) Under no circumstances is alcohol to be consumed on the recreation centre grounds.
6b) Any person drinking alcohol or in the opinion of centre staff or umpires is under the influence of alcohol will be refused entry and asked to leave the recreation centre grounds. Refusal will result in police being contacted.
6c) It is the team captain’s responsibility to make sure all players and spectators affiliated with their team do not consume alcohol in or around the Recreation Centre grounds. Repeated offences may result in the player or team being removed from the competition
7 Rubbish
7a) All players, spectators and officials are expected to place any rubbish in the bins provided.
All team Captains must read and sign the Northam Recreation Centre’s Code of Conduct before competing in our social competitions.
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Code of Conduct
I ______
From :______( team name)
have read and understand the Northam Recreation Centre’s Code of
Conduct. I understand all players, spectators and team officials must abide
by the code of conduct to be part of the Northam Recreation Centre’s social sports.
Signed______
Date: ______
NB: Only this page is to be returned to Recreation Centre staff. Booklet is to be kept by team captain for future reference
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Junior Permission Form for Social Sports
Children Aged between 12 and 16 must have this form signed if they are participating in Social Sports.
I, ______declare that, I will be responsible to ensure that ______will, for the duration of the season, including any finals, honour all forfeit fees, surcharges and suspensions that may be imposed on the team by the competition officials of the Shire of Northam. I declare that on signing this form, accept the competitions fees and charges are subject to change and may increase as per the annual review. I acknowledge and declare that the participant will conduct their behaviour in accordance with Shire of Northam code of conduct and accept any penalties incurred for violating these standards. I also declare that I understand that my child, taking part in any competition may expose themselves or a team member to the possible risk of injury and that the Shire of Northam is not liable for any injury, damages or costs incurred by players as a result of an injury of any nature suffered during the course of play in the competition or in respect to that occurring on the Recreation Centre and its grounds, except to the extent of negligence by the Shire of Northam and indemnify the Shire and its employees in respect thereof. We understand that by playing with an existing injury or pregnancy we may put our bodies at further risk. All players play at their own risk.
Signed______Date ______
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