Kutztown University Athletics - KUFH High School Club Preseason ...
2016 KUTZTOWN FIELD HOCKEY HIGH SCHOOL/CLUB TEAM PRESEASON OUTDOOR TOURNAMENT Who: Any High School Varsity, Junior Varsity, or Club field hockey teams Date: Saturday, August 6th, 2016 Where: Andre Reed Stadium—Turf Surface (Kutztown University Campus) Details: 7 v 7 Tournament in Pool Play, 4 x 25 Minute Games, Rated Officials, PIAA HS Rules Fees: $350.00 PER TEAM or $650.00 for two teams. Please, make checks payable to K.U. Field Hockey and send to: Marci Scheuing, 201 Keystone Hall, Kutztown University, Kutztown, PA 19530. Fee must be received in order to register. Contact: Head Coach—Marci Scheuing, [email protected] or 610-683-4378, or Assistant Coach—Amber Auchenbach, [email protected]. Entry Deadline: July 26th, 2016, Please see attached Entry Form and Waiver
NAME OF TEAM: _______________________________
COACH: _______________________________________
HOME #(
)
CELL#(
)
E-MAIL: ___________________________________
ADDRESS: _______________________________________
_______________________________________
______________________________________ ROSTER: 1.
6.
2.
7.
3.
8.
4.
9.
5.
10.
RETURN WITH CHECK PAYABLE TO: KU FIELD HOCKEY SEND TO: Marci Scheuing FIELD HOCKEY COACH 201 KEYSTONE HALL KUTZTOWN UNIVERSITY KUTZTOWN, PA 19530
WAIVER FORM I understand that I am financially responsible for any medical bills incurred by me during my participation in the Golden Bear Outdoor Tournament. In case of emergency, I grant permission for emergency treatment to be given to me by the appropriate medical personnel. In consideration of the use of premises or facilities owned or operated by Kutztown University and/or in consideration of permitting to participate in the activity listed above, on behalf of myself, my heirs, executors, administrators, successors or assigns. I hereby release and forever discharge Kutztown University, its agents, servants and employees of and from any and all manner of actions, causes of action, suits, damages, claims and demands, on account of personal injury, including death, or any other cause whatsoever, which I may have against them by reason of or arising in the above-listed activity. TEAM NAME: _____________________________ TEAM ROSTER: PRINT NAME:
Parent/Guardian SIGNATURE:
1. _____________________
1. ____________________
2. _____________________
2. ____________________
3. _____________________
3. ____________________
4. _____________________
4. ____________________
5. _____________________
5. ____________________
6. _____________________
6. ____________________
7. _____________________
7. ____________________
8. _____________________
8. ____________________
9. _____________________
9. ____________________
10. _____________________
10. ____________________
NOTE: WAIVER FORM MUST BE COMPLETED AND SUBMITTED PRIOR TO COMPETITION IN ORDER TO PARTICIPATE.***Coaches: Kutztown University is committed to promoting good sportsmanship. Poor sportsmanship or unethical behavior will not be tolerated. Please understand that you are responsible for the conduct of your team, their parents and any spectators. ______________________________ (please sign)
NAME OF TEAM: _______________________________
COACH: _______________________________________
HOME #(
)
CELL#(
)
E-MAIL: ___________________________________
ADDRESS: _______________________________________
_______________________________________
______________________________________ ROSTER: 1.
6.
2.
7.
3.
8.
4.
9.
5.
10.
RETURN WITH CHECK PAYABLE TO: KU FIELD HOCKEY SEND TO: Marci Scheuing FIELD HOCKEY COACH 201 KEYSTONE HALL KUTZTOWN UNIVERSITY KUTZTOWN, PA 19530
WAIVER FORM I understand that I am financially responsible for any medical bills incurred by me during my participation in the Golden Bear Outdoor Tournament. In case of emergency, I grant permission for emergency treatment to be given to me by the appropriate medical personnel. In consideration of the use of premises or facilities owned or operated by Kutztown University and/or in consideration of permitting to participate in the activity listed above, on behalf of myself, my heirs, executors, administrators, successors or assigns. I hereby release and forever discharge Kutztown University, its agents, servants and employees of and from any and all manner of actions, causes of action, suits, damages, claims and demands, on account of personal injury, including death, or any other cause whatsoever, which I may have against them by reason of or arising in the above-listed activity. TEAM NAME: _____________________________ TEAM ROSTER: PRINT NAME:
Parent/Guardian SIGNATURE:
1. _____________________
1. ____________________
2. _____________________
2. ____________________
3. _____________________
3. ____________________
4. _____________________
4. ____________________
5. _____________________
5. ____________________
6. _____________________
6. ____________________
7. _____________________
7. ____________________
8. _____________________
8. ____________________
9. _____________________
9. ____________________
10. _____________________
10. ____________________
NOTE: WAIVER FORM MUST BE COMPLETED AND SUBMITTED PRIOR TO COMPETITION IN ORDER TO PARTICIPATE.***Coaches: Kutztown University is committed to promoting good sportsmanship. Poor sportsmanship or unethical behavior will not be tolerated. Please understand that you are responsible for the conduct of your team, their parents and any spectators. ______________________________ (please sign)
