Youth Basketball League REGISTRATION FORM - Bernalillo County

Youth Basketball LeagueREGISTRATION FORMPlease check one: Male FemaleChild’s Full Name (please print clearly) Date of Birth Age (on 1111/12)Address City State Zip Code5(6 YR OLD 7l8 YR OLD 9l10 YR OLD 11(12 YR OLD LJ13l14 YR OLDFor Ages 9110 and up, please check oneof the two divisions:Silver(Beginnerllntermediate)Gold(AdvancedlCompetitive)Mother IGuardian NameHome#Cell #Mothers Email Address: Work #Father IGuardian NameHome#Cell #Fathers Email Address: Work #Emergency Contact NameChild has following conditions:Phone NumberParticipant Medical HistoryCurrent medications, special diet, allergies:Other Information:Child’s Limitations:T-SHIRT SIZE FOR YOUTH PARTICIPANT ONLY(PLEASE CONSIDER ORDERING ONE (1) SIZE LARGER)(If parents order the wrong size of uniform, then parents will have to pay for an additional uniform.)YOUTH YS YM YLADULT S M L XL XXL XXXLIf possible, please place my child on the same team as:Birth Certificate VerificationPreferred Coach(We will do our best to place your child on yourpreferred team. However, it is NOT GUARANTEED)

Bernalillo County Parks and Recreation Anti-Bullying Disclosure FormIlc’rnalillo County Parks and Recreation is committed to providing caring, friendly and safe environment in arelaxed and secure atmosphere. I3ernalillo County Parks and Recreation will be a zero tolerance establishmentand will not tuh’rafi’ ani type of bullying in our tacilities field, parks or programs.What Is Bullying?Bullying is unfair and one-sided behavior. It happens when someone keeps hurting, frightening, threatening, orleaving someone out on purpose, in person or via multi-media.BLillying can be:• Physical- hitting, kicking, spitting, pushing, inappropriate gestures, taking person belongings• Verbal- taunting, teasing, name calling, gossiping, making threats• SciaI- spreading rumors, manipulating, excluding/isolating, intimidation, interfering with friendshipsof others, cyher bullying, sextingPror’edu resI. Report bullying incidents to staff, either verbally or by leaving calling, emailing or testing the Anti-Bullying help line at 505.933.1113.2. Staff will investigate the allegation by talking to all of the parties separately.3. Staff will use the I lierarchy of Responses-Consequences Guideline Chart.4. The staff will then determine what level of action needs to be taken and will let all parties know theactions taken and what future actions could be if the behavior does not stop.5. For minors, parents will be contacted (or Level 2 or higher or if Level I incidents have occurred on morethan one occasion. (Levels and Explanation on back of sheet)6. If a criminal action has taken place law enforcement will be contacted.Responses [‘or Ages over 181. The person who is acting riggressively will he given a verbal warning and asked to genuinely apologiieor leave the premises.2. After the incident/incidents have been investigated and dealt with, each case will he monitored toensure repeated bullying does not take place.3. After any incident of bullying an incident reporl WILL BE created and filed with management.4. In serious cases or second offenses exclusion will he enacted for up to 1 year and may he reported in lawenforcement.Bcrnalillo Coun fi Con, nutnm,’ntI. If staff witnesses someone bullying another person, they will intervene immediately and address thebehavior in that moment.2. Target and aggressor will always he talked to separately.3. Bystanders will he asked about what happened as well as what they did to intervene.4. Both targel and aggressor will he offered support.1, parent/guardian, of (child’s name), willensure that I and my child are aware of and abide by the I3ernalillo County Parks and RecreationAnti-bullying policyParent/GuardianDATE

Am of the above could be used, but at ntiuimutu the following steps mustbe followed:!‘rO cc d it resUnder 181) Level I- Verbal Warning or Loss of Privilegesa. Specific inappropriate behavior is pointed out tothe participant and they are given an explanationwhy this behavior is inappropriate. The will beasked to correct it. A verbal warning is given notto repeat the behavior. Level 11 -Removal fromGroupcalled in for an inoncdiate conference. Both parties’parents’ will be notified. However, the participantswill NEVER he asked to “mediate” or talk about thesituation in the same room if bullying is identified asa possible problem. If the participant is over 13 andparents are not able to be contacted the participantcan sign the behavior contract. One or all of theCenter’s Administrative Team may participant inthis meeting along with the participant and possiblythe staff person on shift when the incident occurred.b. An Action Plan will he developed at that time. Itwill include the following:i. specific behavior that needs to hecorrectedii. how this will he accomplishediii. time frame in which specified behaviormust he changedc. 5A11 notes/documentation from this meetine. with3) Level III- Suspension or Terminationa. After the above steps have been attempted, with nochange in behavior, the Manager will suspend theparticipant for 1-30 days or terminate theirinvolvement at the center. The Director orAssistant Directors for Bernalillo County Parks andRecreation may review this action. Prior to theparticipants returning to the center, a parentparticipant-staffconference will be scheduled and ari’z:s action plan will be established.1’dI’h’asi’ nob’: In cases of behavior being more severe or criminal in nature, theparticipant may well skip other levels and be suspended or terminated fromparticipation of some or all activities at BCI’R facilities.Level I BehaviorsPushing/kicking/hittingSpittingGossiping/spreading rumorsEmbarrassing or making someonelook foolishMocking or mimickingName-callingDirty looksTauntingTeasing about clothing orpossessionsThreatening to reveal personalinformationGraffitiPublicly challenging to dosomethingDefacing property or clothingr?arickiictingbodilyThreatening with a weaponMaliciously excludingManipulating social order to achieverejectionMalicious rumor mongeringThreatening with total isolation bypeer groupVerbal threats of aggression againstproperty or possessionsVerbal threats of violence or ofinflicting bodily harmThreats of using coercion againstfamily and friendsCoercionLevelAnt1 ‘i ‘lie fotlou’ing respanscs:(;rtu’ meeting on appropriate andexpected behaviors with everyone,not singling anyone outLoss of privilegesVerbat warningParent notifiedTime-out (5-15 minutes asked toseparate themselves from thegroup)t’attem of level I offenses mayresult in Level 2 responseb. After repeated verbal warning has been givenwith no change in the behavior, the participant ts removed from the group in a “time out” fashion for 5-15minutes. After this time out period, the participant is asked whether he/she wishes to rejoin the group andclinngt’ their bchaz.’inr. If yes, participant rejoins the group. If no, a supervisor is called. Level II Code ofConduct violation and above automatically results in the behavior being documented using art IncidentReport. it is placed in the participant’s file. Parent’s will be called and informed of the situation2) Level III- Parent Conferencea. Verbal warnings and removal from the group have proven unsuccessful. At this level, parents will be,.;,.-...-level 2 BehaviorsDefacing PropertyStealingDemeaning physical acts that arenot physically harmfullocking in a closed or confinedspaceEthnic slursSetting up to take the blametiumiliating publiclyLxctuding from groupSocial rejectionTeasing about appearanceIntimidating telephone callsTaking possessionsExtortionSexual or racial taunting..411l’..4mtheparticipant’sLevel 2 Responsest’arent contacted and any of thefollowing responses:Loss of privileges (progressivelymore severe than Levet 1)Making amends:Repairing, cleaning and repla ingitem (natu rat consequences)Writing a report on the topicCommunity service or monetaryretributionSeparation from other youthduring activitiesShort-term suspension fromprogramPattern of Level 2 offenses mayresult in response for Level 3responses.tffile.Required parent conferencewith coach/or staff memberand any of the followingresponses:Behavior plan (outtine‘t expected behaviors in writingwith next steps)Referral to one-on-one orsmall-group interventionsessionsShort-term suspension forone to ten days fromprogramExpulsionCriminal behavior will bereferred to law enforcementfor further action.