We Embody: RESPECT, CARING, HONESTY, RESPONSIBILITY, Scott Country Family Y AND SPORTSMANSHIP 2019-2020 Program Information Youth Sports Program Information $30 for Members $50 for Community Track, Volleyball, Flag

Fall 2019 Fall 2019 Spring 2020 Fall 2019 Winter 2020 Spring 2020 Football, and Machine Program Machine Flag Track and Volleyball Volleyball Volleyball Pitch Program Pitch Football Field

Boys/Girls Boys/Girls Boys/Girls Boys/Girls Boys/Girls Boys/Girls Age 6 - 8yrs 5 - 8yrs 6 - 10yrs 6 - 10yrs 5 - 14yrs 5 - 14yrs

Riverdale Eisenhower Riverdale Bettendorf Location Davenport Y Davenport Y Heights Elem Heights High

Registration Sept 17th Sept 17th Nov 9th Feb 13th April 10th April 15th Ends

Dates of Sept 8th - Sept 12th - Nov 5th- Jan 21st - April 2nd- April 5th - Program Oct 13th Oct 24th Dec 17th March 3rd May 14th May 31st

1:00 - 5:30- 5:30 - 5:30 - 5:30 - 12:00 - Time 2:30pm 7:30pm 7:30pm 7:30pm 8:30pm 3:00pm

Late Fee Aug 26th Aug 26th Oct 15th Jan 6th March 23rd March 23rd Begins

Questions? Refund Policy Please don’t hesitate to reach out If the program is cancelled by the Y a full credit or refund will be given. Credits or refunds will Scott County Family Y 606 W 2nd Davenport, IA 52801 to our Youth Sports Staff at (563) be given on the unused portion if the 322-7171 ex. 133 or email us at www.scottcountyfamilyy.org participant is dealing with an injury, major [email protected] illness or moving from the Quad City area. Expectations for 5-9yr old Activities We Embody: RESPECT, CARING, HONESTY, RESPONSIBILITY, AND SPORTSMANSHIP Experience the excitement with trying a new sport! Our passion for these sports is endless as we work side by side with you. 2019 – 2020 Registration Form

Participant’s Name: ______Expectations for 10-14yr old Activities Youth Program: ______

Being older brings more fun and excitement! Location of Program: R.Heights Eisenhower Davenport Y Bettendorf High Gender: M / F Birthdate: ______/______/______Age:______Address: ______Location Information Parent/Guardian:______We understand your time is valuable! That’s why we provide Cell Phone #: (______) ______various locations, for you and your family, at Riverdale Heights, Email Address : ______Eisenhower, the Davenport Y, and Bettendorf High School. School Attending: ______Player Request: ______Income Based Financial Assistance Available Coach Request: ______We are striving to meet the needs of a dynamic community. We know Reversible Jersey’s can be purchased at your local Y-Branch for $16, these Jersey’s every family & household is different and our plan is to tailor a are required for all programs. membership to meet your needs! Our Programs will not run 100% without you!! Please consider volunteering! You At the Y, no one is turned away due to their inability to pay. Our will be provided with game rules and practice ideas to help you! Coaches and As- sistants are responsible for scheduling practices, treat signups, contacting the rest Annual Campaign makes membership affordable and available of the team, etc. to everyone. Contact a local branch for further questions. Head Coach: Yes No Assist Coach: Yes No All Sports Weather Information Wavier of Liability and Promotion Information regarding rainouts and postponements will be The Scott County Family Y (hereinafter referred to as the “Y”) is not obligated to furnish any insurance under the communicated through these media outlets as well as to your Y program referred to above although it may do so without obligation as to the adequacy of any insurance it might furnish. I, the parent or guardian of the applicant agree that the Y and all individuals participating in the Y coach. The Y will decide when to cancel the activities. program, in any capacity, will not be liable for any causes of actions, claims, and injuries arising out of the partici- pation of the applicant in the Y program, and hereby release all said individuals from such claims and liabilities. The undersigned acknowledges that in all sports there are certain risks of physical injuries and all players partici- pate at their own risk. I, as legal guardian or parent of applicant, hereby consents to the participation of the YMCA Weather Line : (563) 529-4640 applicant in the Y program under the above mentioned conditions. I, also agree to abide by the young athlete’s bill of rights. I give my consent for this player to be photographed, videotaped, and/or filmed while participating Find Us on Facebook at Scott County Family YMCA in any Y activity and for the resulting photos , etc or be used by the Y for educational and promotional purposes. I have read and understand the above: Signature:______Date: _____/_____/______