BUDDHIST CHURCH OF OAKLAND YOUTH CLUB
BASKETBALL PLAYER APPLICATION
2007 - 2008
PLAYER INFORMATION
Last Name
First Name
Street Address
City & Zip Code
Member - Buddhist
Church of Oakland?
Yes
Birth Date
(MM/DD/YY)
Gender
/
Male
No
Home Phone
/
Age & Grade (as
of 12/1/07)
Female
-
Age
Grade
Height & Weight
Team / League
Yes
Player of
Japanese
Ancestry?
/
No
List previous
basketball
experience with
dates
Japanese Surname:
Played When?
Team / League
Played When?
Team / League
Played When?
Did player participate in the basketball program sponsored by the Buddhist Church of Oakland last season? Yes
If “Yes”, did Player and Family meet their required Service Commitments for last season? Yes
No
No
.
.
If Player and Family did not satisfy Service Commitments for prior season, please attach explanation for not meeting required
Service Commitments as outlined and described in last season’s application package.
PARENT / GUARDIAN INFORMATION
Father
Mother
Name (First and Last)
Address
(if different from player’s)
Home Phone
(if different from player’s)
Same
Same
(St. Address, City, Zip Code)
(St. Address, City, Zip Code)
Same
Same
/
-
/
-
Work Phone
/
-
/
-
Cell Phone
/
-
/
-
E-mail Address
Page 1 of 6
BUDDHIST CHURCH OF OAKLAND YOUTH CLUB
MEMBERSHIP AGREEMENT
2007 – 2008
Player’s Name (First & Last Name)
hereby makes application for membership in the Buddhist Church Of Oakland Youth Club (BCOYC) under the
following terms and conditions:
1. Membership. The undersigned parent(s) and player understand that as a condition of participating on a
BCOYC basketball team, the Board of Directors of the Buddhist Church of Oakland (BCO) and league rules
require that the participant be a member of the sponsoring organization. Upon acceptance as a member of
the BCOYC, the undersigned parent(s) and player shall be entitled to participate in BCOYC activities as long
as the undersigned parent(s) and player continue to fulfill their obligations to BCOYC.
2. Player Participation Fee. In order to help defray the cost of sponsoring the various basketball teams, each
player shall pay a “player participation fee” and the fees for the 2007 - 2008 Season are as follows: $200 for
the first player, $175 for the second player, and $150 for each additional player (siblings) in a family. A check
made payable to “BCOYC” in the required amount must accompany this Membership Application and
Agreement. Scholarships are available and further information can be obtained from the President of the
BCOYC. Members of the Buddhist Church of Oakland receive a $50 per player discount on player
participation fees. Please write the player’s name on the check.
3. Player Volunteer Service Commitment Deposit. A separate check for $150 made out to the “BCOYC” and
postdated August 1, 2008 must be given to the BCOYC before the first game of the season. A player cannot
play if this check is not received by the BCOYC. This check will be returned to the parent(s) or the player
upon successful completion of the player and family volunteer service commitment requirements. This check
will be deposited if the player and family fail to meet their volunteer commitment requirements. Please write
the player’s name on the check.
4. Obligations and Responsibilities.
No player shall be allowed to participate in a Buddhist Church of Oakland Youth Club (BCOYC) activity who
has not returned the completed and signed BUDDHIST CHURCH OF OAKLAND YOUTH CLUB
MEMBERSHIP AGREEMENT, Emergency Medical Attention Authorization, and applicable League
Application.
To maintain player eligibility in the BCOYC basketball program, each family must participate in a minimum of
three of the four major fundraising and service events during the twelve-month period beginning each
September 1st. Please note the four major service commitment dates:




Mochi Tsuki (December)
Pancake breakfast (mid-February)
Bazaar (Father’s Day weekend)
Obon (first weekend in August)
Players are required to provide community service hours during these major events as assigned by the
BCOYC. Additionally, one parent or guardian per player must also provide service hours during these events.
http://buddhistchurchofoakland.org/youthclub1.htm
Membership in the BCOYC and player eligibility may be revoked or denied for players of families failing to
fulfill their service commitments.
5. Code of Ethics. The undersigned player acknowledges that he/she has read the Code of Ethics as described
below and agrees to conduct himself/herself in accordance therewith at all times while participating in BCOYC
activities. The undersigned parent(s) acknowledge that they have read the Code of Ethics and agree to abide
by them and to make every effort to see that their child complies.


Everyone must respect the rights and property of other participants and residents.
All participants are strictly prohibited from drinking any alcoholic beverage or using illegal drugs of any
kind at any time during a BCOYC activity. Any violation of this provision shall be grounds for expulsion.
Page 2 of 6



All participants must be within the confines of the BCOYC activity at the specified and agreed upon times.
All participants will be responsible for keeping their respective coaches or designated leaders informed as
to their whereabouts at all times during a BCOYC activity.
All participants will be responsible for their behavior and actions to their own and opposing team
members, coaches, parents, and designated leaders, as well as league and game officials.
Any violation of the above provisions will be investigated and individuals may be requested to leave the site of the
activities with forfeiture of their registration and other fees. Also, violations of the above provisions may be
subject to further review by the BCOYC and additional penalties may be imposed.
6. Indemnification, Hold Harmless, Release of Liability. As a condition of membership in the BCOYC and
participation in BCOYC activities, the undersigned parent(s) and player hereby agree to release, indemnify,
and hold BCO, BCOYC, and their board members, officers, coaches, managers and agents harmless from
any and all liability, claims, actions, losses, damages, injuries, and judgments which may arise from the
member’s participation in any BCO or BCOYC activities.
7. Term. Upon acceptance as a member of the BCOYC, this application shall become the agreement that shall
govern the member-organization relationship for a period of one year from the date of this application. Either
party may, however, terminate the agreement at will.
SIGNATURES (both parents must sign unless a single parent household):
Parent / Guardian
Date
(MM/DD/YY)
/
/
Parent / Guardian
Date
(MM/DD/YY)
/
/
Player
Date
(MM/DD/YY)
/
/
Date
(MM/DD/YY)
/
/
Membership accepted by BCOYC:
Coordinator
Page 3 of 6
EMERGENCY MEDICAL ATTENTION AUTHORIZATION AND EMERGENCY CONTACT INFORMATION
2007 - 2008
Player’s Name (First & Last Name)
In the event of illness, accident, or other medical emergency which may occur during any game, excursion or
other activity of the player’s team, permission is hereby given to any adult leader (coach, manager, officer or
board member) of the Buddhist Church of Oakland Youth Club (BCOYC) to authorize, by his or her signature,
whatever medical, surgical or dental treatment is deemed necessary or advisable by a physician, registered
nurse, dentist, or emergency medical technician in attendance.
It is understood that when possible, BCOYC adult leaders will attempt to secure the advice of the parent or
guardian by telephone prior to giving the authorization contemplated herein.
Player’s Physician
(First & Last Name)
Physician’s Phone Number
/
-
/
-
Home Phone
/
-
Cell Phone
/
-
None
or:
Health Insurance Carrier
Policy No.
Health Carrier Phone No.
Emergency Contact Name
(First & Last Name)
Relationship
List any medical conditions such
as allergies or sensitivities to
particular drugs, foods, etc.
SIGNATURE:
Parent / Guardian
Date
(MM/DD/YY)
Page 4 of 6
/
/
This form is for BOYS B, C & D Players and ALL E Players
EAST BAY YOUTH ATHLETIC LEAGUE
2007 – 2008* SEASON
NAME: ______________________________________________________________________________________
Last
First
Middle
ADDRESS:___________________________________________________________________________________
Street
City
Zip Code
SCHOOL: ____________________________________________________________________________________
Now Attending
City
Grade
ENROLLED IN
KINDERGARTEN: _____________________ BIRTHDATE: ____________________________________
Year
Month
Day
Year
TEAM AFFILIATION:
Buddhist Church of Oakland Youth Club
Present
_____________________
Alternate Choice*
**Coach and Division __________________________________
*PURPOSE OF ALTERNATE CHOICE: In event your sponsoring organization cannot field a team, your child may be
offered an opportunity to play on the team of your alternate choice. If the alternate choice is left blank, the decision of
where your child may play will be left up to the EAST BAY YOUTH ATHLETIC LEAGUE Board. Any change
regarding your alternate choice should be given to the EBYAL Board in writing prior to the season you wish to make
the change.
**COACH AND DIVISION: For returning players, please specify if you have a preference for the coach and division
(E Bronze, E-Silver, E-Gold, D-Silver, D-Gold, C-Silver, C-Gold, B-Silver or B-Gold). For new players, please specify
if you have a preference for a particular coach only. Preferences will be accommodated to the extent that they do not
conflict with the need to comply with league rules and the need to create well matched teams in their respective
divisions.
_______________________________________________________
Signature of Parent or Guardian
__________________________
Date
WAIVER AGREEMENT:
It is understood by the undersigned applicant and their parents or guardian that the EAST BAY YOUTH
ATHETIC LEAGUE and its Board Members, the sponsoring church or organization, its officials and
members or participating facilities shall not be liable for any injury sustained by the applicant while
playing, practicing, traveling or participating in any activity sponsored by the EAST BAY YOUTH
ATHLETIC LEAGUE or its member organizations. The signing of this application shall be considered as
a waiver of any claim for such injury.
NAME: _____________________________________ DATE: __________________
Signature of Player
TELEPHONE: __________________
NAME: _____________________________________ DATE: __________________
Signature of Parent or Guardian
TELEPHONE: __________________
__________________________________________
_____________________
Medical Insurance Carrier
Policy #
Page 5 of 6
This form is for Girls B, C and D Divisions Only
EAST BAY GIRLS ATHLETIC LEAGUE
REGISTRATION AND INDEMNITY
Please Print or Type
Registering for Team/Organization Name
Buddhist Church Of Oakland Youth Club
Last Name
First
Previously
Registered?
Middle
No_____Yes_____
If so, which team?
Age
Street Address
City
Zip
Date of Birth
School
Grade
Height
Weight
(
Name of Parents or Legal Guardian
)
Telephone
I hereby agree that my daughter, named above, may participate in the basketball events sponsored by
the East Bay Girls Athletic League- (“League”) during the 2007-2008* season. She will play with the
Buddhist Church Of Oakland Youth Club team.
As consideration for having my daughter participate in events sponsored by the League or its sponsor
organizations, I hereby waive all claims against the League, its officers, Commissioners, coaches, team
managers and sponsoring churches or organizations and their officers and board, members (hereinafter
referred to as the "League”), for personal injury, death, and loss or damage to property including theft,
and release and discharge the "League” from any liability related to or in any way connected with my
daughter's participation in those events, including travel to and from such events.
In addition, I agree to indemnify, defend, protect, and hold harmless the "League”, from and against all
claims, damages, liabilities, losses, and expenses, including but not limited to attorneys' fees, in whole or
in part arising out of, resulting from or in connection with my daughters participation in any activities
sponsored by the "League", even if such claim, damage, liability, loss or expense should arise from the
negligence of the "League”. However, my agreement to indemnify, defend, protect and hold harmless in
the preceding sentence shall be applicable only to the extent insurance proceeds paid by insurance
carried by the League does not cover the amount of the claim.
Date
Date
Signature of Both Parents or Legal Guardian
Page 6 of 6