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HomeMy WebLinkAboutJimmy Yagi Summer Hoops Camp Returns to Hilo July 21-24 (News Release, Registration Form, Consent & Release of Claims)f+Q•• �r William P. Kenoi ;. Mayor r � ountp 0f'a'biai' i DEPARTMENT OF PARKS AND RECREATION 101 Pauahi Street, Suite 6 • Hilo, Hawaii 96720 (808) 961-8311 9 Fax (808) 961-8411 http://www.hawaiicounty.E!ov/parks-and-recreation/ NEWS RELEASE April 29, 2015 FOR IMMEDIATE RELEASE Clayton S. Houma Director Kenneth J. Van Bergen Deputy Director Jimmy Yagi Summer Hoops Camp Returns to Hilo July 21-24 The County of Hawaii Department of Parks and Recreation invites Hawai`i's keiki basketball players to the 3 d Annual Jimmy Yagi Summer Hoops Camp that will be held July 21-24 in Hilo. Open to boys and girls 9 to 17 years old, the Jimmy Yagi Summer Hoops Camp is named in honor of the legendary former University of Hawaii at Hilo basketball coach who helped guide the Vulcans-Hawaii Basketball School for 37 years. It will be held at the Afook-Chinen Civic Auditorium and the Pana`ewa Covered Play Courts. UH -Hilo women's basketball coach David Kaneshiro has graciously agreed to share his basketball expertise and serve as lead clinician for the four-day camp. Assisting Kaneshiro will be Daphne Honma, Honoka`a High School girls basketball coach and a former Division II coach of the year. Additional college coaches are expected to serve as camp clinicians. Teenage campers will receive personalized instruction from a team of coaches as they practice agility, ball -handling and other drills from 9 a.m. to 1 p.m. daily. Players will showcase their skills by competing in games from 2 p.m. to 4 p.m. Campers 9 to 12 years old will receive similar instruction from 9 a.m. until noon and will play games between 1 p.m. and 3 p.m. Early registration is $60 per child. The cost will rise to $70 for players registering after Monday, July 13. All participants will receive a camp shirt and group photo. Please make checks payable to the Director of Finance and include the note "Jimmy Yagi Summer Hoops Camp." Registration forms will be available starting Monday, May 4, at the Department's Recreation office located within Aunty Sally Kaleohano's Luau Hale at 799 Pi`ilani Street in Hilo and online at http://www.hawaiicounty.gov/parks-and-recreation/. For more information, please contact Jason Armstrong, Public Information Officer, at 961-8311 or jarmstronq(a�hawaiicounty.gov. -30- County of Hawai'i is an Equal Opportunity Provider and Employer. COUNTY OF HAWAII DEPARTMENT OF PARKS AND RECREATION REGISTRATION FORM / CONSENT / RELEASE OF CLAIMS Date Form Filled Out , 20 DISTRICT Hilo SPORT/ACTIVITY 311 Annual Jimmy Yagi Summer Hoops Basketball Camp (July 21-24, 2015) FACILITY Aaes 9-12. 9 am -3 om Panaewa Plav Courts & Aaes 13-17. 9 am -4 om Afook-Chinen Civic Auditorium *All ages must show up at the Afook-Chinen Civic Auditorium on the first day of the camp Tuesday, July 21st at 8:00 am to register. Please bring water and snack. No lunch will be provided. Please check SHIRT SIZE: Youth L M Sml Adult XL L M Sml PARTICIPANT'S NAME GENERAL INFORMATION (Please Print) (Last) (First) (MI) AGE BIRTHDATE PARENT/LEGAL GUARDIAN PHONE (home) (Last) (First) (MI) MAILING ADDRESS PHONE (work) SCHOOL PHONE (cell) 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 disability to effectively participate in our program? Please Check One: 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 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. 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) Printed Name of Witness Phone Number Address City Zip Code Rev 5/23-06 Signature of Parent or Legal Guardian Possession or consumption of alcohol by persons under 21 is prohibited. County of Hawaii is an Equal Opportunity Provider and Employer 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 Hawaii 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. There is also the 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 INDEMNIFICATION In consideration of permission granted to participant by the County of Hawaii, Department of Parks and Recreation, to participate in the activities listed on the previous page: I/we hereby release the County of Hawaii, 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 Hawaii, 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 Hawaii, 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 I will encourage, but not force, my child to participate in any program or event. I will remember that children participate to have fun, and that the program/event is for youth, not adults. 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 person's or team's chance to win. I will not ridicule or yell at my child or any other participant for making a mistake or losing. 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. 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. 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. 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. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 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