Release Form - Piscataway Dojo (Page 2 of 4) in pdf

Release Form - Piscataway Dojo Page 2

Piscataqua Dojo / Piscataway Dojo

Piscataway Recreation Department

Piscataway, New Jersey

Model Code of Conduct

Youth Sports Programs play a very important role in the promotion of the physical,

social, and emotional development of children. It is therefore essential for parents,

coaches, officials and spectators to encourage youth sports participants to embrace the

values of good sportsmanship. Moreover, adults involved in youth sports events should

be models of good sportsmanship and should lead by example by demonstrating

fairness, respect and self-control.

In accordance with this mission, the Piscataway Township Council has adopted a

Model Code of Conduct ordinance for Piscataway Recreation programs as well as Little

League and Soccer Club programs. Township Ordinance 03-41 is in accordance with

New Jersey Public Law 2002, Chapter 74.

Parents and legal guardians of Piscataway Recreation programs participants are

required to read and sign this Model Code of Conduct on behalf of themselves and their

children. This document must be submitted at the time of program registration.

Children cannot be registered or begin program participation without submitting a

signed registration form and a signed Model Code of Conduct form.

After reading the Model Code of Conduct found on the reverse side of this form, both

parents/guardians and Player must sign below.

_________________________

_______________________

Participant’s Name

Participant’s Signature

Date

_________________________

_______________________

Print Father’s Name

Father’s Signature

Check here if Single Father

_________________________

_______________________

Print Mother’s Name

Mother’s Signature

Check here if Single Mother

Complete and Return this form with your registration.

Release Form - Piscataway Dojo Page 2