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Home My WebLink About2023 Hawaii International Futsal Cup)ULY 27-29, 2023 SPENCER "KALANI" SCHU OPENING CEREMONY FREE CLINIC POOL PLAY - ALL DIVISIONS FRIDAY, JULY 28, 2023 POOL PLAY - ALL DIVISIONS FRIENDSHIP GAMES SATURDAY, JULY 29, 2023 PLAY-OFFS a CHAMPIONSHIPS AWARD CEREMONY TEAM REGISTRATION PACKETS AVAILABLE ONLINE AT: FOR MORE INFORMATION, CALL THE RECREATION DIVISION OFFICER 18081961-8140 kO,l EMAIL RECREATION@HAWAIICOUNTY.GOV r iJiY��rr�� ► �r ��r..ti i11T'f'it T, County of Hawai'i — Department of Parks and Recreation 2023 Hawai'i International Futsal Cup EVENT DATES: Thursday, July 27 — Saturday, July 29, 2023 DIVISIONS: Girls: 10U, 12U, 14U, 16U Boys: 10U, 12U, 14U, 16U Open Women's & Open Men's SCHEDULE OVERVIEW: Thursday, July 27 Opening Ceremony/Clinic/Tournament Games Friday, July 28 Tournament Games Saturday, July 29 Tournament Games/Championship Games/Awards Ceremony SITE: Spencer Kalani Schutte District Park— Play Courts 67-1315 Ala Ohia Road, Kamuela, HI 96743 (808) 887-1906 REGISTRATION DOCUMENTS / FORMS DUE: FRIDAY, JUNE 30, 2023 • Team Roster & Registration Form • Registration Form/Consent/Release of Claims (ONE FORM PER PARTICIPANT/COACH) • Copy of Birth Certificate (Only for 10U, 12U, 14U and 16U divisions) • Email a copy of your team logo to recreation@ hawaiicounty.gov • Individual youth wanting to participate in Youth Futsal Camp check box on Team Registration Form • HIFC Fee: $350.00 per team (3 game minimum) o Check made payable to County of Hawaii — Director of Finance o Due with Registration Documents by June 30, 2023 o Mail in a certified check or money order. No personal checks allowed. • ALL REGISTRATION DOCUMENTS / FORMS DUE TO THE RECREATION DVISION OFFICE EITHER BY EMAIL, HAND -DELIVERY OR POSTAL MAIL. o Email to recreation@ hawaiicounty.gov o Hand -deliver or mail to 799 Pi'ilani Street; Hilo, HI 96720 YOUTH FUTSAL CAMP: Clinicians: From Japan - Kiyoshi Sagane and Kenta Fujii; From Brazil — Tiago Oliveira Date: Thursday, July 27 Site: Spencer Kalani Schutte District Park— Play Courts — Court 3 Schedule: 12U Division: 11:OOam-12:OOpm 14U Division: 12:OOpm-1:OOpm 10U Division: 1:OOpm-2:OOpm 16U Division: 2:OOpm-3:OOpm Cost: FREE! Division: (circle selection) Girl's 10U 12U 14U 16U *' Boy's 10U 12U 14U 16U -` - Women's Open / Men's Open 9TF OF "µPAP County of Hawai'i — Dept. of Parks and Recreation 2023 Hawai'i International Futsal Cup TEAM ROSTER & REGISTRATION Team Name: Primary Contact / Coach's Name: Secondary Contact Name: Phone: Phone: Name of Player Uniform # Month Day Year Age Shirt Clinic Size Participant EX. Jane Doe 00 Jan. 01 2010 13 Youth Med ✓ 1 2 3 4 5 6 7 8 9 10 Shirt Sizes are available in Youth — Small, Medium, Large and Adult — Small, Medium, Large, X-Large COUNTY OF HAWAI'l DEPARTMENT OF PARKS AND RECREATION REGISTRATION FORM / CONSENT / RELEASE OF CLAIMS Date Form Filled Out , 20 DISTRICT Hilo SPORT/ACTIVITY Hawaii International Futsal Cup FACILITY Spencer Kalani Schutte District Park DATES July 27-29, 2023 GENERAL INFORMATION (Please Print) PARTICIPANT'S NAME _AGE BIRTHDATE_____ (Last) (First) (MI) PARENT/LEGAL GUARDIAN PHONE (home) (Last) (First) (MI) MAILING ADDRESS PHONE (work) PHONE (cell) HEALTH & EMERGENCY INFORMATION PLEASE LET US KNOW ANY MEDICAL INFORMATION RELEVANT TO THE CARE OF YOUR CHILD (Note: epi-pens, inhalers, or medication storage require ADDITIONAL emergency forms to be completed at least 2 weeks before program begins.) CHILD'S DOCTOR PHONE HEALTH PLAN EMERGENCY CONTACTS other than parent/guardian listed above: NAME PHONE RELATIONSHIP NAME PHONE RELATIONSHIP We are committed to creating accessible recreation programs. Does your child need modifications due to a disability to effectively participate? (i.e. personal assistant, behavior plan, modified activity, wheelchair accessible field trips, other.) Please Check One: YES, my child requires a modification NO, my child does not require a modification O If yes, please complete a Modification Request with our Recreation Specialist, ph. 808-961-8681, TTY 808-961-8736. Adult attendants or skills trainers who accompany a child in our P&R programs must register before the first day of the program. Late registration will delay your child's start date. MEDIA RELEASE I/We hereby give permission to the Department of Parks & Recreation, County of Hawaii, to allow the news media to film and photograph program activities provided: 1) They are for news and non-commercial purposes; 2) The program director determines the filming, etc., will not unduly interfere with or disturb the programs; and 3) Individual children are not singled out for demonstrating photography or interview purposes against their wishes. Please Check One: YES, permission granted NO, permission denied (If no box is checked, assumption is "No, permission denied") CONSENT In consideration of the permission granted to me by the County of Hawaii, State of Hawaii, for my minor child ("Child") to participate in the above -mentioned sport/activity ("Activity"), the above -named PARENT/LEGAL GUARDIAN ("Parent") consents and agrees that: a. Child is allowed to actively participate in Activity; b. Child is participating voluntarily, and with Parent's approval and consent. c. Child is in reasonably good physical and mental health, such that Minor can safely participate in Activity. d. Parent recognizes and understands that participation in the Activity involves risk of death, personal injury and/or property damages, commonly inherent in such Activity. e. Parent shall notify a representative from the Department of Parks and Recreation if there is any change in Child's physical and/or mental condition such that MINOR cannot safely participate in Activity. f. The Department of Parks & Recreation may refer Child, if injured or ill, to my family doctor when I cannot be reached. When there is no family doctor, the Department has the discretion to select a doctor. I also agree: 1. I have read BOTH SIDES of this registration form, including the Informed Consent, Assumption of Risks, Code of Conduct, and Release of Claims on the back side of this page. 2. 1 understand and agree with all of its terms. 3. 1 have filled out the information on this form fully and completely. 4. 1 will notify the County immediately in writing of any changes to the information above. 5. 1 am signing this form voluntarily and with full knowledge of its significance. IN WITNESS WHEREOF, I have executed this Registration, Consent and Assumption of Risks, Release of Claims and Indemnification and Code of Conduct at on the day and year first written above. (Place of Execution) Signature of Witness (Age 18 or Older) Printed Name of Witness Address Phone Number City Zip Code Signature of Parent or Legal Guardian The County of Hawai'i is an equal opportunity provider and employer. Rev 5/23-06, 8/12, 4/17 INFORMED CONSENT AND ASSUMPTION OF RISKS The Department of Parks and Recreation provides a wide variety of activities and programs for persons of all ages in a safe and pleasant environment. However, there are certain inherent risks in almost every activity. Please read the following informed consent categories to acquaint yourself with the risks involved. If you are making a determination that your child is able to participate in any activity, it is your responsibility to assess your child's maturity, health/fitness and ability to obey safety rules and decide if the risks associated with these activities are acceptable to you. While the County of Hawai'i hopes that every participant enjoys an injury -free activity, by signing this Release of Claims form, you assume all risks associated with the activity for which you have registered your child. Please ask any questions of the instructor which you may need to make a fully informed decision for your child to participate. Certain sport activities, such as football, basketball, baseball, and volleyball may have physical contact. All contact sports necessarily and unavoidably carry with them the risk of high-speed collisions with other persons, balls, and equipment. In addition, irregular playing surfaces may be present and a child may be at risk for falling or minor lacerations. There are, therefore, risks of orthopedic, dental, cervical, spinal, head or other types of injury. There is also risk of lacerations and other injury from falling and/or colliding with people or objects. In addition, all sports require a level of fitness and health that only your physician can determine you or your child possesses. We strongly urge that you obtain medical advice as to whether contact sport activities are suitable for your child. Many undetected or chronic diseases such as cardiac disease or high blood pressure may be worsened by participation in these activities. Activities such as ceramics, painting, or cooking are examples of types of activities which may involve supplies or ingredients which may be toxic when ingested, inhaled or when coming in contact with skin. There may also be allergic reactions or individual sensitivity to these supplies or ingredients when ingested, inhaled, or when in contact with skin. Swimming at the beach or pool is another activity with inherent risks involved. RELEASE OF CLAIMS AND INDEMNIFICAITON In consideration of permission granted to participant by the County of Hawai'i, Department of Parks and Recreation, to participate in the activities listed on the previous page: I/We hereby release the County of Hawai'i, its agents, employees, and independent contractors from all actions, causes of action, damages, claims, or demands which I, my heirs, personal representatives, or assignees may have against the County of Hawai'i, and other above -named parties for all injuries, known or unknown, which may incur by my child's participation in the above -described activity or by my child's use of the above -described facility. I/We do further agree that I shall indemnify and save harmless the County of Hawai'i, or any of its officers or employees, either jointly or severally, from any and all claims, demands, damages, loss of service, or expense for property damage and for personal injuries or actions brought by a third party resulting or arising from my child's participation in the above - described activity or my child's use of the facility. PARTICIPANT'S & PARENT'S CODE OF CONDUCT 1. I will encourage, but not force, my child to participate in any program or event. 2. 1 will remember that children participate to have fun, and that the program/event is for youth, not adults. 3. 1 will pay close attention to the physical conditioning and well-being of my child and will refuse to jeopardize the health of any individual for the sake of improving a person's or team's chance to win. 4. 1 will not ridicule or yell at my child or any other participant for making a mistake or losing. 5. 1 (and guests) will be positive role models for my child, and encourage sportsmanship by showing respect and courtesy, and by demonstrating positive support for all staff, players, coaches, officials, and spectators at every game, practice, tournament, or event. 6. 1 will respect officials and their decisions. I will not argue with an official in public, and will not yell, swear or be verbally abusive. Any discussion of constructive comment shall be done in an unemotional and calm manner. 7. 1 will not engage in any physical or verbal confrontation or altercation before, during or after any program, game or vent, with officials, coaches, players, staff, or spectators. Doing so shall result in immediate action by the police and the Director of the Department of Parks and Recreation. 8. All P&R activities are drug and alcohol free for participant and adults. Anyone found to be under the influence, intoxicated, or in possession of any of these will be TERMINATED from participating in the program. The police and the Director of the Department of Parks and Recreation will be notified. I have read and understand the Informed Consent and Assumption of Risks, Release of Claims and Indemnification, and Code of Conduct on this page 2. Signature of Parent/Legal Guardian Mitchell D. Roth Mayor `'� Ali;'• Hl •ON;.�w:r�� T6 OF•M�,� douttfV of �afvztlfii DEPARTMENT OF PARKS AND RECREATION 799 Piilani Street • Hilo, Hawaii 96720 Phone: (808) 961-8740 —Fax: (808) 961-8736 Maurice C. Messina Director Michelle Malia Hiraishi Deputy Director SPORTS PROGRAMS CODE OF CONDUCT GUIDELINES SPORTS PROGRAM COACH'S GUIDELINES: Definition It is a requirement of all clubs/teams affiliated with County of Hawaii Sports Programs to assume responsibility for the conduct of all athletes, coaches and spectators under their jurisdiction. Goal Statement Violation of the Guidelines for Behavior of Coaches, Athletes and Spectators will be dealt with under County of Hawaii Discipline Policy. (Rule 9-Rules and Regulations of the Department of Parks and Recreation of the County of Hawaii). Guidelines for Coach's Behavior ✓ Be a Leader, a positive influence and role model. ✓ Reward effort, fair play and commitment. ✓ Recognize and respect the differences in your athletes. ✓ Demonstrate respect for all individuals involved in the game. (Game officials, scorekeepers, timekeepers, gym directors.) ✓ Always consider the physical and emotional well being of the athletes. ✓ Communicate in a positive and rational manner. ✓ Respect and coach within the spirit of the game. ✓ Always attempt to contribute to the betterment of the game. County of Hawaii is an Equal Opportunity Provider and Employer. Page 2 of 4 SPORTS PROGRAM ATHLETE'S GUIDELINES: Definition Anyone who participates in an athletic activity is considered an athlete. It is expected that each athlete will compete to the best of his or her abilities at all times, keeping in mind the spirit of competition and of the game. Goal Statement Any athlete participating in any County of Hawaii sanctioned events or those who participate leagues/tournaments/clinics etc. at all County of Hawai'i facilities will be expected to adhere to the following guidelines for behavior. Guidelines for Athlete's Behavior ✓ FAIR PLAY is an athlete's first priority. ✓ Participate for the love and enjoyment of the game. ✓ Respect the efforts and accomplishments of your team-mates and your opponents. ✓ Respect officials, coaches, spectators and event organizers. ✓ Respect the facility you visit or in which you play. ✓ Respect the rules of the game. Any physical or verbal confrontation or altercation before, during or after any program, game or event with officials, coaches, players, staff, or spectators will not be tolerated. Doing so shall result in immediate action by the police, and the Director of the Department of Parks and Recreation. Which includes but not limited to a one-year suspension from all County Facilities. County of Hawaii is an Equal Opportunity Provider and Employer. Page 3 of 4 SPORTS PROGRAM OFFICIAL'S GUIDELINES: Definition Officials at a County of Hawaii Department of Parks & Recreation event are participants in enriching the experience of athletes and coaches competing in the game. As such, it is expected they shall exercise a high level of self-discipline, independence and responsibility. Goal Statement The purpose of this Code is to establish guidelines for standards of conduct for officials who are officiating Parks & Recreation events. Guidelines for Official's Conduct: Officials shall master both the rules of the game and the mechanics necessary to enforce the rules, and shall exercise authority in an impartial, firm and controlled manner. ✓ Officials shall work with each other and the Parks & Recreation in a constructive and cooperative manner. ✓ Officials shall uphold the dignity of the profession in all interactions with athletes, coaches, team managers, scorekeepers, timekeepers, recreation personnel and spectators. ✓ Officials shall prepare themselves both physically and mentally, shall wear the approved league uniform, and shall conduct themselves in a manner consistent with the high standards of the profession. ✓ Officials shall be punctual and professional. ✓ Officials shall remain mindful that their conduct influences the respect that athletes, coaches and spectators hold for the profession. County of Hawaii is an Equal Opportunity Provider and Employer. Page 4 of 4 SPORTS PROGRAM SPECTATOR'S GUIDELINES: Definition "Spectator" Anyone watching an athletic activity or event whether sitting or standing. A spectator may be a parent, a relative, friend, teammate, opposing player, administrator or coach not directly involved in the game. Spectators are an important part of any athletic activity, however they are not essential. Spectators should never influence the outcome of an event and must never pose a distraction to players, other spectators, timers, scorekeepers or referees. Goal Statement Anyone in an audience as a spectator at a County of Hawaii sanctioned event will be expected to adhere to the following Guidelines for Behavior (Rule 9). Actions Always model mature behavior consistent with County of Hawaii Guidelines for Behavior. Those are: ✓ Support the Game. ✓ Stress the importance of participation. ✓ Avoid spectator imposed pressures to win. ✓ Be supportive of the athlete, team, coach, opponents and officials. ✓ Maintain a supportive, constructive atmosphere conducive to personal development. ✓ Refrain from negative communication with players, coaches, the scorers' table or game officials. ✓ Remain in the spectators' section, and refrain from entering the playing area at any time. County of Hawaii is an Equal Opportunity Provider and Employer. E Food Truck Area Court #3 Viewing Area Viewing Area Outside Patio Eating Area BACK Entrance and Exit Net Barrier Net Barrier Net Barrier Net Barrier Net Barrier 4 Office Exit only Concession FRONT Area Entrance and Exit Viewing Area Viewing Area SPENCER "KALANI" SCHUTTE DISTRICT PARK KAMUELA, HAWAI'I Women/Men Restroom Court #1 4 Exit only X 0 7 m X 0