HomeMy WebLinkAbout2013 Hershey's Track and Field Youth Program (March 9, 2013)
Clayton S. Honma
William P. Kenoi
Director
Mayor
Robert A. Fitzgerald
Deputy Director
DEPARTMENT OF PARKS AND RECREATION
799 Piilani Street Hilo, Hawai’i 96720
(808) 961-8740 Fax (808) 961-8736
Dear Coaches/Parents,
The Hawaii County Department of Parks and Recreation, with sponsorship from the National
Recreation and Park Association, National Association for Sports and Physical Education,
Athletics Canada, and Hershey Foods Corporation and Mauna Loa Macadamia Nut Corporation,
will be hosting a local meet for the Hershey’s annual Track and Field Youth Program.
The state sponsor, Hawaii Recreation and Park Society and its local members will conduct the
meet with assistance from the Department of Parks and Recreation.
Date: March 9, 2013
Time: Registration – 9:00 – 9:45 am
Track meet - 10:00 am
Place: Keaau High School Track & Field Oval
ENTRY DEADLINE – Thursday, February 28, 2013.
Send or Mail entry form and County of Hawaii Registration form to:
Department of Parks and Recreation
Recreation Division
799 Piilani St.
Hilo, Hi. 96720
Fax – 961-8736
All participants must bring a legal birth document to the meet.
The official local entry form must be completed for each individual entrant and signed by a Parent
or Guardian. Also, a completed and signed Department of Parks and Recreation registration must
be submitted with the official local entry form.
Please make copies of the packet for any interested individual from your school or club.
For more information call Darrell Yamamoto at 961-8735 or cell 938-2012, or email
dyamakoa@gmail
Go to www.hersheystrackandfield.com for more information.
Entry form and Registration form can be obtained from the County of Hawaii website.
http://www.hawaiicounty.gov/pr-recreation/
IMPORTANT REMINDERS
All times and distances will be compared with the other island meets, to determine the
state finalists. Thereafter, times and distances will be compared with other states in
Region 2, (Arizona, California, Nevada and Utah). It is at this point that the regional team
is selected to represent the region at the North American Finals in Henry Hershey Field in
Hershey, Pa.
Only participants, with Hershey t-shirts, and meet officials are allowed on to the track
oval.
Jewelry (including beads in the hair, necklaces, earrings or pierced rings, etc.),
sunglasses (except prescription) shall not be allowed during competition. Participant will
be disqualified if he or she competes with jewelry or sunglasses.
Each participant will receive a T-shirt at registration. The t-shirt must be worn to gain
entry onto the track oval. If the t-shirt impedes the participant in any way, it may be
removed during the event, but must be worn after completion of event or any time he or
she is on the track oval.
Each competitor is responsible for promptly reporting for each event entered. He or she
must report to the Clerk of Course or bull pen for any running events or the designated
area for field events.
Attendants may not accompany a competitor to the starting area. Any competitor will be
disqualified if, in the opinion of the meet referee, the runner has in any way been aided by
a coach, teammate or anyone connected directly or indirectly with the individual
concerned. Such aid includes running alongside a teammate, being stationed at various
points near the track, or located near any of the field events for the purpose of aiding or
coaching the competitor after the race or field event has been started.
When there are a great number of entries in a given event, the meet committee will
determine the placement of participants in heats.
All participants will be listed in their chosen events. Please call 961-8735, if for some
reason a registered participant is unable to attend the meet, so deletions can be made to
the list. Change of events will not be allowed on day of the meet. All changes must be
faxed to 961-8736.
No pets allowed on school grounds
.
No tents or beach umbrellas allowed on stadium seating.
A concession booth will be open throughout the day.
Go to www.hersheystrackandfield.com for more information.
.
FOR IMMEDIATE RELEASE
Department of Parks and Recreation
Recreation Division
799 Piilani Street
Hilo, HI. 96720
Darrell Yamamoto
961-8735
Hershey’s Track and Field Youth Program
The Hershey Track and Field Youth Program has involved millions of youngsters from all 50
states, the District of Columbia and the 10 provinces and 3 territories of Canada. It is sponsored
by the National Recreation and Park Association, the President’s Council on Physical Fitness and
Sports, the National Association for Sport and Physical Education, Athletics Canada and Hershey
Foods Corporation. Local co-sponsors include the Hawai`i County Department of Parks &
Recreation, Hawai`i Recreation and Park Society and the Mauna Loa Macadamia Nut
Corporation.
The local track meet will be held on Saturday, March 9, 2013, at the Keaau High School Track &
Field Oval. Winner’s times and distances will be compared with results of other local meets
throughout the state. State winners do not automatically advance to the North American Final.
They are entered into a regional pool and become eligible for selection to a Regional Team which
will travel to Hershey, Pennsylvania, to compete in the North American Final, held August 1-4,
2013.
The entry deadline is February 28, 2013. (No late registrations will be taken after this date). For
entry forms please call the Recreation Division office at 961-8740, during the hours of 8:00 am to
4:00 pm, Monday through Friday. All necessary forms and information will be mailed
immediately upon request. Entry form & Registration form can also be obtained from:
http://www.hawaiicounty.gov/pr-recreation/
The meet is open to boys and girls of the Big Island, 9 to 14 years old as of December 31, 2013.
Events will include the 50 meter dash, 100 meter dash, 200 meter dash, 400 meter dash, 800 meter
run, 1600 meter run, 4x100 meter relay, standing long jump and softball throw.
Hershey’s Track and Field Youth Program is designed to encourage physical fitness among youth
and emphasize participation and sportsmanship.
THE HERSHEY YOUTH PROGRAM IS DESIGNED FOR THE BEGINNER ATHLETE
Meet Date: March 9, 2013 (Saturday)
Time: 10:00 am to 3:00 pm (Approximate)
Place: Keaau High School Track Oval
REGULATIONS
ELIGIBILITY:
Open to 9-14 year old girls and boys born between 1999-2004, who reside in Hawaii. Six divisions based on gender and age as
December 31, 2013. must
of All participants compete in their gender and age group division.
ENTRY DEADLINE:Thursday, February 28, 2013 – 4:00 P.M.
Department of Parks and Recreation
Mail or Fax to:
799 Piilani Street
Hilo, Hawaii
ATTENTION: Darrell Yamamoto
PHONE: 961-8740 FAX: 961-8736
EQUIPMENT: Shorts, t-shirts, and shoes are required. Track shoes (with or without spikes) are not permitted.
Starting blocks are not allowed.
PROOF OF AGE:A legal birth document must be presented for viewing upon registration on meet day.
Age is determined by the age the youth will be on December 31, 2013.
Shirt Size: Please Circle One
GIRL BOY
Please check the appropriate box:
GENDER:
Youth – Med Large
PLEASE TYPE OR PRINT IN BLACK INK
Adult – Small Med Large
NAME____________________________________________________________________________
LAST FIRST
MI
ADDRESS_______________________________________________________________ PHONE NO._____________________________
STREET CITY/ZIP
DATE OF BIRTH: MONTH________ DAY________ YEAR (circle one) 1999 /2000 / 2001 / 2002 / 2003 / 2004
PROGRAM: _______________________________________ COACH’S NAME____________________ PHONE #_________________
(Name of Summer Fun Program,, track team, school. If none, write Unattached)
Circle participant’s gender. Select up to three (3) events—not more than 2 running events.
GENDER BIRTH YEAR Select no more than 2 running events (the relay is a running event) St. Long Jump* Softball Throw*
G: 4’, B:4’6” G: 50’, B: 65’
GIRL 2003/2004 50M DASH 100M DASH 200M DASH 400M DASH 4X100 RELAY
BOY
GENDER BIRTH YEAR Select no more than 2 running events (the relay is a running event) St. Long Jump* Softball Throw*
G: 4’6”, B: 5’ G: 75’, B: 90’
GIRL 2001/2002 100M DASH 200M DASH 400M DASH 800M RUN 4X100 RELAY
BOY
GENDER BIRTH YEAR Select no more than 2 running events (the relay is a running event) St. Long Jump* Softball Throw*
G: 5’, B:6’ G: 100’,B: 110’
GIRL 1999/2000 100M DASH 200M DASH 800M RUN 1600M RUN 4X100 RELAY
BOY
* Note: Qualifying distances must be met to compete in the STANDING LONG JUMP AND SOFTBALL THROW EVENTS!
4x100M RELAY – Limited to 2 teams per division per organization. If you are a member of a relay team, you must list the other members of your relay team
TEAM NAME:
1 2 3 4
ALT 1 ALT 2 ALT 3
The above named participant, the participant’s parent/guardian have requested registration of the participant in the Hershey Youth Program. In consideration of such registration, the
right of the participant to compete in the Hershey
Youth Program and the use by the participant of the sponsoring agency’s facilities, and equipment, both the participant and the parent/guardian each acknowledge that the participant
will be competing in the Hershey Youth Program
and sponsoring agency’s facilities at the participant’s sole risk and the participant on his/her own behalf and on behalf of his or her heir, executors, administrators and assigns, and
parent/guardian shall indemnify, save and hold
harmless The Hershey Company and its franchises and the National Recreation and Parks Association, USA Track & Field, Athletics Canada, Hawaii Recreation and Park Society, Keaau High
School (DOE) and the Department of
We understand that those participants who advance to the state/provincial level and are winners at this level do not automatically advance to the regional level for the North
Parks and Recreation of Hawaii County.
American Final Meet. This is covered under Rule 9, Article 1 in the rule book.
We also agree to allow the Hershey Youth Program to use and reproduce the participant’s name and/or likeness and /or information concerning the
participant and to circulate the same for any and all purposes in any manner. We certify that the information on this participation form is correct
______________________________________________
Print Name__________________________________ Date______________________________________
Signature of Parent or Legal Guardian
In case of Emergency, Contact__________________________ _____________________________ Relationship_________________________________________
Or _______________________________________________ _____________________________ Relationship_________________________________________
I have checked this application and confirm its accuracy (coach/parent/guardian’s signature) __________________________________________________________
ENTRY DEADLINE: February 28, 2013 - 4:00 P.M.
Go to www.hersheystrackandfield.com for more information
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 you 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 your 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. lacerations and other injury from
There is also the risk of
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
allergic reactions or
which may be toxic when ingested, inhaled or when coming in contact with skin. There may also be
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.
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RELEASE OF CLAIMS AND INDEMNIFICATION
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 childs participation in the above-
described activity or by my childs 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 childs participation in the above-described activity or my
childs use of the Facility.
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PARTICIPANTS & PARENTS CODE OF CONDUCT
1. I will encourage, but not force, my child to participate in any program or event.
2. I will remember that children participate to have fun, and that the program/event is for youth, not adults.
3. I 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 persons or teams chance to win.
4. I will not ridicule or yell at my child or any other participant for making a mistake or losing.
5. I (& 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. I 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 or constructive comment shall be done in an unemotional and calm manner.
7. I will not engage in any physical or verbal confrontation or altercation before, during or after any program, game or event,
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 & Recreation.
8. All P&R Activities are drug and alcohol free for participants 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 & Recreation will be notified.
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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
COUNTY OF HAWAI`I
DEPARTMENT OF PARKS AND RECREATION
REGISTRATION FORM / CONSENT / RELEASE OF CLAIMS
Date Form Filled Out _______________, 20____
DISTRICT____________________________________FACILITY_____Keaau High School Track & Field Oval_____
SPORT/ACTIVITY______HERSHEY’S TRACK & FIELD – March 9, 2013________ AGE GROUP__ _9-14 years old__
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)
SCHOOL _________________________________________________________GRADE_________________________
HEALTH & EMERGENCY INFORMATION
PLEASE LET US KNOW ANY MEDICAL INFORMATION RELEVANT TO THE CARE OF YOUR CHILD:
____________________________________________________________________________________________________________
CHILD’S DOCTOR _________________________________ PHONE _________________ HEALTH PLAN _____________________
EMERGENCY CONTACTS other than parent/guardian listed above:
NAME ___________________________________________ PHONE _________________ RELATIONSHIP_____________________
NAME ___________________________________________ PHONE _________________ RELATIONSHIP_____________________
We are committed to making our recreation programs accessible. Does your child need modifications due to a
Please Check One:
disability to effectively participate in our program? _____ YES _____ NO
If yes, please complete a Modification Request with our Recreation Specialist, ph. 961-8740 ext .24, TTY 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.
MEDIA RELEASE
I/We hereby give permission to the Department of Parks & Recreation, County of Hawai`i, 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 Hawai`i, State of Hawai`i, 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.
BOTH SIDES
I also agree: 1. I have read 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. I understand and agree with all of its terms.
3. I have filled out the information on this form fully and completely.
4. I will notify the County immediately in writing of any changes to the information above.
5. I 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) Signature of Parent or Legal Guardian
__________________________________________
Printed Name of Witness Phone Number
__________________________________________
Address City Zip Code
Possession or consumption of alcohol by persons under 21 is prohibited.
County of Hawai‘i is an Equal Opportunity Provider and Employer
Rev 5/23-06