STATE COLLEGE ASSEMBLY OF GOD
BOYS DEVELOPMENTAL FOOTBALL PROGRAM
2201 University Drive Extension, State College, PA 16801
Phone: 238-3800, Fax: 238-5430
website: http://www.scassembly.org/football
email: [email protected]
txt messaging: http://trunc.us/fNUh13 to sign up
Spring MNF, Summer Camp, Fall Program
January 1, 2013
Dear Young Man,
I want to share with you some information about an exciting and fun program in the State College Area. You may have
participated before; or heard about us; or maybe you are a young man that I have met or heard about in the community.
What am I talking about? It’s the State College Assembly of God Boys Developmental Football Program. We will have
nearly 400 boys participate in one of our three programs for 2013 (Spring Monday Night Football MNF, Football Summer
Camp and Fall Program – Flag, Pee Wee and Midget).
There is information and registration forms throughout this packet. This is our fifth season of Spring MNF focusing on
football exercises, skills development and fun playing flag football games. A fantastic program to practice skills, learn the
game and see if football is your sport. The last week of July is our 16th annual Football Summer Camp. This intensive
nightly camp will focus on skills – blocking, tackling, catching, throwing, running, coverage, offense, defense, special
teams, speed/agility, competitions and flag football games. Also included is info for our traditional Fall Program – Flag,
Pee Wee and Midget. This year the divisions will be divided by weight (on 07/27/13) and age (as of 08/01/13).
Fall Program:
 USA Football Affiliated
 USA Football designated pilot program for “Heads Up Football”
 Flag, Pee Wee and Midget
 Developmental – USA Football Certified Coaches
 NINETEENTH Season
 ALL activities in State College – NO travel
 EVERY player plays minimum half of the game – small team rosters = maximum playtime
o In 2012 we had 6 flag teams, 4 pee wee teams and 4 midget teams – YES 14 teams
 ALL Flag players and MAJORITY of Pee Wee and Midget players touch the ball sometime during the season
 OFFENSIVE backfield skills rotation
 TWO practices and ONE game per week with NO Sunday activities
 Electronic Scoreboard, Delay-of-Game Timers and Football Building at the SCAofG game field
 ONE Fundraiser
 “Super Bowl Saturday” BOWL GAMES at SCASD Memorial Field in October
 KEEP your game jersey at the end of the season
Dads who want to be Coaches or Helpers at practices and/or games need to fill out the enclosed form and contact John
Potter at 238-3800 or email at [email protected] to get clearance to participate for the 2013 season. In addition all
coaches will participate in USA Football Coaching Education.
You will see advertisements and be hearing about this soon among your friends. Enclosed you will find all the
information that you need. You can also visit our open houses on:
Tuesday, March 12
Monday, April 8
Wednesday, May 8
Tuesday, July 9
Feel free to share this with your friends in your neighborhood, school, church, etc. I hope to see you in 2013 playing
some football with other young men, just like yourself.
Sincerely,
John Potter
John Potter,
Program Director
13 Mailing.01 - Program Packet Cover Letter.doc
State College Assembly of God - Boys Developmental Football Program - 2013
Program Vision, Guidelines, Highlights, and Rules
Program Vision:
Utmost and foremost we want to give glory to God and our Savior, Jesus Christ in all that we do.
The State College Assembly of God Boys Developmental Football Program has a two-fold purpose. First, to give men an
opportunity in a favorable setting to share their Christian faith with boys in the State College and surrounding
communities. We will emphasize character development and Christian values. Second, to develop fundamental
individual and team football skills and techniques in boys who have an interest in playing football. We will emphasize
conditioning, flexibility, fitness, dedication and good sportsmanship. We reach these goals and this vision by doing the
following:
Christian Faith: We are a Community Christian Program. Each practice, game, meeting, activity, etc. will have
Christian prayer. Coaches will lead out in prayer (players may also if they desire). Coaches and Volunteers will also
share scriptures and how they apply to today's challenges and opportunities for the boys. All participants will be
expected to treat others, as they would want to be treated. Foul language, fighting, taunting, trash talking, etc. will not be
tolerated.
Football Open Houses: Look for our booth on Saturday, February 9 at the State College Area School District Youth Fair,
Mount Nittany Middle School; Tuesday, March 12; Monday, April 8; and Wednesday, May 8 from 6-8pm each night; and
Tuesday, July 9 from 5:30-7:30pm at State College Assembly of God and other Central Pennsylvania events.
Spring Monday Night Football (MNF): Starting on Monday, April 15 is our fifth season of MNF – football exercises, a
special guest will conduct a mini-clinic on a football specific skill, then teams will be formed, short team practices will
occur and flag football games will complete the evening. This season we will be blessed to have One on One in State
College do a planned progressive football exercise program with our players. In addition to some very special guests,
many SCAHS football players came out to coach our flag teams in previous seasons.
“Football Night in State College Event” (Community Cleat Swap/Alternative Skills/Coaches Clinic/Pre-Season Camp
Meeting): Tuesday, July 9 from 5:30-7:30 pm the community cleat swap will be open. Bring your old, do not fit
anymore, cleats and exchange for a pair that do. Pick up a pair of cleats for a small donation. Discount coupons from
local stores will be available for equipment purchases. A cleat swap coordinator is being sought. 5:30-6:30 pm
alternative skills for the fall program are available. 6:30-7:15 pm will feature a coaches clinic. 7:15-7:30 pm pre-season
camp info for all coaches who are helping out. We will also hold an open house throughout the evening.
Football Summer Camp: July 22-25 are the dates for our 16th annual intensive week night camp. We are very excited
about the talent and knowledge of the volunteers who are going to teach at this year’s camp. In the past 15 years we have
had many local college coaches and players visit our camp as special guests to share their love of football and speak with
our campers. Local inter-scholastic coaches and players assist our USA Football certified coaching staff in teaching
skills. The first three nights are focused on team and individual skills – offense, defense, special teams, and speed/agility.
Stance blocking tackling, running, throwing, catching, kicking, punting, receiving, coverage, etc. Wednesday night will
feature QB challenge, punt/pass/kick and 40-yd dash competitions. Thursday night will finish the week with flag football
games.
Fall Football Program: Boys will be divided by weight, age and skill level in teams of 14-16. Practices will be
somewhat intense and demanding. FOR PEE WEES AND MIDGETS THIS IS A FULL CONTACT FOOTBALL
PROGRAM. Conditioning, exercising, stretching, and flexibility will be stressed. Basic individual football skills will be
taught including running, stance, blocking, tackling, catching, throwing, etc. Team football skills will also be taught
including formations, schemes, offense, defense, kicking, plays, etc. Coaches will teach each player two offensive and
defensive positions. Coaches may hand out playbooks or individual plays for the boys to memorize. A coach once said
that this is not a contact sport, but it is a collision sport. Coaches will work very hard with each boy to prepare him for
game situations to minimize the possibility for injury. Coaches will determine playing time and positions on each team
keeping in mind physical capability, mental focus, dedication, game fatigue, work ethic, etc.
FALL PROGRAM INFO
Registration is now open: Those registering on time will receive a break in the cost of the Program. Only Complete
Registrations will be accepted this year. 2013 Fall Program Divisions are: Flag, Pee Wees and Midgets.
Program Divisions: Ages on August 1, 2013 and weights at the Skills Days on July 26 and 27, 2013
Flag Football 8 teams – up to 1 in season weigh-in for ALL players
6 years old
7 years old
8 years old
Pee Wee Football 6 teams – up to 3 in season weigh-ins for ALL players and ½ lb per week weight allowance
9 years old
10 years old and up to 110 lbs
11 years old and up to 90 lbs
For 2013 there is a backfield weight limit of 90 lbs. Players over 90 lbs will play on the line of scrimmage in a three-point
stance.
Midget Football 4 teams – up to 3 in season weigh-ins for ALL players and ½ lb per week weight allowance
10 years old and up to 160 lbs – must have special permission from program director to play
11 years old and up to 160 lbs
12 years old and up to 160 lbs
7th grade and 13 years old and up to 160 lbs
8th grade and 13 years old and up to 130 lbs
For 2013 there is a backfield weight limit of 130 lbs. Players over 130 lbs will play on the line of scrimmage in a three-point
stance.
The backfield weight allowances will also increase by ½ lb per week. All weights will be taken on the "Official League
Scale" and no other weights on any other scale will be considered. At in-season weigh-ins those players who do not make
weight will not be allowed to play until they can make weight. The number of and date of in-season weigh-ins will be
determined by the program director as time permits.
Participants Code of Conduct: A participant’s code of conduct is attached and will need to be signed and returned with
the registration form.
Equipment Handout and Skills Day: On Friday, July 26 for Flag and Saturday, July 27 for Pee Wees and Midgets we will
hand out equipment, measure weights and evaluate the skills of all players in the league. Participation is required unless
special arrangements are made with the Program Director. As in past years an alternative skills evaluation will be set up
during the football camp and the “Football Night in State College Event.” Those not making the equipment handout will
receive their equipment at the first practice.
Team Sizes: Tackle football teams will start with 14-16 players. Keeping team sizes small maximizes playing time for all
players according to their ability. When a team is below 14 players, then additional players may be added by the Program
Director from the league waiting list until the team has at least 14-16 players. These players must be on the Program
Director's list, completed registration and paid their fee prior to receiving equipment and clearance to play. If there are
not 16 players per team then an equal number of players will be given to each coach and players who register late will be
added to the teams in the draft order at the Program Director's discretion. The ideal flag football team is 11-13 players.
Player Selection: Each tackle football team will retain up to 4 players from last year's team (usually coach's sons). Each
flag football team will retain up to 3 players from last year's team (usually coach's sons). The coaches and the Program
Director will rate the skills of these players to determine level of ability in comparison to other players in the league.
These players will be given a round of draft to evenly balance the teams prior to the draft. These players will be graded as
Superstars (1st round picks) if 2013 skills are unavailable. The Program Director will determine a draft selection order
using the following: 2012-year standings, previous year’s standings and coaching experience. Once a selection order is
determined, then the coaches will select the teams.
Commitment, Practices and Games: This is a three day per week program. It is very important that the players (and
their families) make a dedicated commitment to the program and make all practices and games. Games are already
scheduled and teams will rotate thru the various times/days. Parents please keep in mind that there is a balance with
small team rosters vs. player commitment to make all activities. Small team rosters allows coaches to meet the program
requirements for minimum play time. When players do not attend practices or games, families should consider that the
attending players may not be as successful as a team due to lack of a full roster at that activity. Please consider this prior
to signing up.
Flag will be Tuesday or Thursday night game; Wednesday night skills/team practice 5:25-7:00 pm; and Saturday team
practice pre-season is 11:00 am-12:30 pm and in-season is 9:00-10:30 am.
Flag will always practice with practice jerseys, game pants and cleats.
Pee Wee will be Monday night practice 5:30-7:30 pm; Wednesday night practice 5:30-7:30 pm; Friday night practice
(pre-season only) 5:30-7:30 pm; and Friday/Saturday games.
Midget will be Tuesday night practice 5:30-7:30 pm; Thursday night practice 5:30-7:30 pm; Saturday morning practice
(pre-season only) 9:00-11:00 am; and Friday/Saturday games.
Pee Wee and Midget: The first week of practice will be in helmets, cleats, shorts and t-shirts. Following weeks
will be in full equipment. Players will need to have cleats, protectors (cups) and practice jerseys. The league will
provide everything else. Cleats and protectors (cups) may be purchased at local stores for practice/games.
Practice jerseys for all program divisions in team colors will be available for $10 each.
All activities will be at the Church or State College area fields.
Play Time: Will be determined by the head coach of each team with input from his assistants. All players on a team are
not going to play the same amount of time in a game. This is especially true of the scrimmage day which may result in a
player not playing as much, because the coach knows what he can do and the coach may need to see other players react in
a “game” situation. Experienced, mentally focused, dedicated, stronger, faster players are going to play more. Every
player needs to strive to improve at each practice to secure his playtime. Every head coach is required to play every
player one-half of each game unless special disciplinary actions are being taken or the player is not prepared to play that
much time. Additional playtime is earned. Many times during every season we see many players playtime increase as
they improve.
Pee Wee and Midget Heads Up Football Events (NEW FOR 2013):
ALL Coaches – Wednesday, July 31 at 5:30 pm: equipment fitting; concussion awareness; tackling
technique; league rules and division specific rules will be handed out and discussed.
ALL Players and Parents – Thursday, August 1 at 5:30 pm: Heads Up Football program; equipment
check; concussion awareness; tackling technique; practice and season schedules; practice jerseys on sale.
Flag Football League Rules and Division Specific Rules: Will be handed out to head coaches at the mandatory head
coaches meeting on Monday, August 12. Assistant Coaches and helper Dads are also welcome to attend.
Coaches and Team Parents: Coaches and Team Parents are the backbone of this program. Men interested in participating
this year as head coaches, assistant coaches, helpers should contact John Potter. Any of the men directly participating
with the players during practices and/or games will need to be have a background check and child abuse clearance to
participate. All coaches will need to complete USA Football coaching education to participate. There are many other
opportunities to volunteer so any parent or friend of the program who is interested then he or she should contact the
Program Director and his or her Head Coach (prior to participating). We appreciate the assistance of all of the families
who make the program go.
Concessions Stand: The concessions stand will be open at games with drinks, foods, candies, snacks, etc. We are always
looking for a few helping hands at the concessions stand. Contact Lisa Spalsbury to volunteer.
In 2013 – we are looking for a Tuesday night coordinator during flag practices & games (8 evenings), Wednesday
night coordinator during flag practice (7 evenings), Thursday night coordinator during flag games (6 evenings) and
Friday night coordinator during pee wee and midget games (6 evenings).
In 2013 - each team will supply a teen or adult to staff the concessions stand during their game.
Games and Game Officials: Volunteers will be needed to operate our scoreboard, delay of game timers, down-markers
and chains. Contact Curt Spalsbury to help out. Game officials will be under the supervision of PIAA official, John
Stacy. We are looking for 18 years or older men who want to become PIAA officials to lead our officiating crews. Please
contact John Potter if you are interested, we can help with the costs of this commitment. We will be looking for young
men to assist in officiating games. If you know of a high school or college man who has some football knowledge and
would like to earn a few dollars officiating games, please let us know. Officials will be paid $10-35 per game depending
on years of service and PIAA certification.
Hoagie/Pizza Sale and Awards Night: Again this year one of the highlights of the program will be our annual awards
nights. We will have our annual Marianna’s fund-raiser for the players to do their part. In years past families who could
not participate made a donation to help cover the evenings costs. Contact Nancy Potter to volunteer with the sale.
13 Mailing.02.04 - Program Vision.doc
State College Assembly of God - Boys Developmental Football Program – 2013 as of 03/01/2013 (updated)
Spring MONDAY NIGHT FOOTBALL – spring football program (April thru June)
7:15 p.m. - 8:00 p.m. Monday, April 8 - MNF pre-season meeting for coaches and volunteers
5:30 p.m. - 8:00 p.m. each Monday (April 15, 22, 29 & May 6, 13, 20 & June 3, 10)
Football Night in State College Event (Community Cleat Swap, Alternative Skills, Coaches Clinic/Meeting)
5:30 p.m. - 7:30 p.m.
5:30 p.m. - 7:30 p.m.
5:30 p.m. - 6:30 p.m.
6:30 p.m. - 7:30 p.m.
July 9 (Tuesday)
Football Open House
Community Cleat Swap
Alternative Skills
Coaches Clinic/Meeting
Summer Football Camp
July 22 - 25
5:30 p.m. - 8:30 p.m. each day (Monday - Thursday)
(Alternative Skills for campers will be during the camp)
Cost $45 ($30 if paid and pre-registered by JUNE 1 - $15 discount)
FALL Flag Football Registration
Cost: 1 player - $60, 2 players - $110 (if registered after JUNE 1)
Cost: 1 player - $50, 2 players - $ 90 (discount if paid and registered by JUNE 1)
FALL Pee Wee and Midget Registration
Cost: 1 player - $80, 2 players - $140, 3 players - $195 (if registered after JUNE 1)
Cost: 1 player - $70, 2 players - $120, 3 players - $165 (discount if paid and registered by JUNE 1)
FALL Flag and Pee Wee or Midget Registration
Cost: 1F+1PW/M - $125, 2F+1PW/M - $170, 1F+2PW/M - $180 (if registered after JUNE 1)
Cost: 1F+1PW/M - $105, 2F+1PW/M - $150, 1F+2PW/M - $165 (discount if paid and registered by JUNE 1)
FALL Equipment Handout and Skills Evaluation
(Participation is required)
Flag, Friday, July 26- Equipment - 5:30 - 6:00 pm and Skills - 6:00 - 7:00 pm
Flag Draft (coaches only), Friday, July 26 - 7:00 - 9:30 pm
Pee Wee, Saturday, July 27 - Equipment - 9:00 -10:00 am and Skills - 10:00 - 11:00 am
Pee Wee Draft (coaches only), Saturday, July 27 - 1:30 - 3:15 pm
Midget, Saturday, July 27 - Equipment - 11:30 -12:30 pm and Skills - 12:30 - 1:30 pm
Midget Draft (coaches only), Saturday, July 27 - 3:15 - 4:45 pm
NOTE #1: Brothers will be placed on the same team within a program division. All teams within each program division will
practice together.
NOTE #2: Only those players who have completed the registration process may get equipment, participate in the skills and be
placed on a team. Others will be placed on teams (if spots are still available) by the program director after completing registration.
Pee Wee and Midget Heads Up Football Event for ALL Coaches July 31 at 5:30 pm (NEW FOR 2013)
Fitting Equipment, Concussion Awareness, Heads Up Tackling, League Rules of Play
Pee Wee and Midget Heads Up Football Event for ALL Players and Parents
August 1 at 5:30 pm (NEW FOR 2013)
Equipment check, Concussion Awareness, Heads Up Tackling, Practice and Season Schedules, Practice Jerseys on Sale
FALL First Week of Practice
August 5 - 10 (Monday-Saturday)
Helmets, T-Shirts, Shorts, Cleats - Pee Wees and Midgets
Conditioning, Basics, Heat Acclamation
Monday – Pee Wee at 5:30 pm
Any Pee Wee needing equipment should meet at the equipment shed 4:00 – 5:30 pm
Tuesday – Midget at 5:30 pm
Any Midget needing equipment should meet at the equipment shed 4:00 – 5:30 pm
Wednesday – Pee Wee at 5:30 pm
Any Pee Wee needing equipment should meet at the equipment shed 4:00 – 5:30 pm
Thursday – Midget at 5:30 pm
Any Midget needing equipment should meet at the equipment shed 4:00 – 5:30 pm
Friday – Pee Wee at 5:30 pm
Saturday – Midget at 9:00 am
NOTE: Flag Football Practice Starts on Saturday, August 10 at 11:00 am.
Any Flag needing pants – meet at equipment shed 10:30 – 11:00 am
Flag Parents Meeting: Saturday, August 10 for Flag at 12:40 pm Practice and Season Schedules hand out.
Practice Jerseys will go on sale at the first practices.
FALL Second Week of Practice
August 12 - 17 (Monday-Saturday)
Full Equipment - Pee Wees and Midgets
Monday – Pee Wee at 5:30 pm
Any Pee Wee needing equipment should meet at the equipment shed 4:30 – 5:30 pm
Tuesday – Flag at 5:30 pm (game field)
Any Flag needing pants – meet at equipment shed 5:00 – 5:30 pm
Tuesday – Midget at 5:30 pm
Any Midget needing equipment should meet at the equipment shed 4:30 – 5:30 pm
Wednesday – Flag at 5:25 pm (game field)
Any Flag needing pants – meet at equipment shed 5:00 – 5:25 pm
Wednesday – Pee Wee at 5:30 pm
Any Pee Wee needing equipment should meet at the equipment shed 4:30 – 5:30 pm
Thursday – Midget at 5:30 pm
Any Midget needing equipment should meet at the equipment shed 4:30 – 5:30 pm
Friday – Pee Wee at 5:30 pm
Saturday – Midget at 9:00 am
Saturday – Flag at 11:00 am (practice fields)
FALL Third Week of Practice
August 19 -22 (Monday-Thursday)
No Practice on Friday or Saturday due to scrimmage - Pee Wees and Midgets
Game Jerseys will be handed out by head coaches at the end of practice: Flag – Wed, Pee Wee – Wed, Midget – Thurs
Monday – Pee Wee at 5:30 pm
Any Pee Wee needing equipment should meet at the equipment shed 4:30 – 5:30 pm
Tuesday – Flag at 5:30 pm (game field)
Any Flag needing pants – meet at equipment shed 5:00 – 5:30 pm
Tuesday – Midget at 5:30 pm
Any Midget needing equipment should meet at the equipment shed 4:30 – 5:30 pm
Wednesday – Flag at 5:25 pm (game field)
Any Flag needing pants – meet at equipment shed 5:00 – 5:25 pm
Wednesday – Pee Wee at 5:30 pm
Any Pee Wee needing equipment should meet at the equipment shed 4:30 – 5:30 pm
Thursday – Midget at 5:30 pm
Any Midget needing equipment should meet at the equipment shed 4:30 – 5:30 pm
Scrimmage and Picture Day and Bake Sale
August 24 (Saturday)
Flag, Pee Wee and Midget individual and team pictures will be taken. All teams will scrimmage on the game field.
Our sixth annual bake sale for capital projects will be held at the football building/concessions stand.
Flag Football: Games on Tuesday and Thursday Nights with an end of the season awards night.
Tuesdays
August 27
September 3
September 10
September 17
September 24
October 1
5:30 p.m. & 6:40 p.m.
5:20 p.m. & 6:30 p.m.
5:10 p.m. & 6:20 p.m.
5:00 p.m. & 6:10 p.m.
4:50 p.m. & 6:00 p.m.
4:40 p.m. & 5:50 p.m.
Flag Game Schedule (subject to change):
Thursdays
August 29
5:30 p.m. & 6:40 p.m.
September 5
5:20 p.m. & 6:30 p.m.
September 12
5:10 p.m. & 6:20 p.m.
September 19
5:00 p.m. & 6:10 p.m.
September 26
4:50 p.m. & 6:00 p.m.
October 3
4:40 p.m. & 5:50 p.m.
Flag Awards night is Monday, October 14
Equipment Turn In 6:45 p.m. - 7:00 p.m.
Awards Program 7:00 p.m. - 8:00 p.m.
Snacks after the Program
Pee Wee & Midget Program: Games on Friday Nights and Saturdays.
Fridays
August 30
September 6
September 13
September 20
September 27
October 4
Bowl Games:
6:00 p.m.
6:00 p.m.
5:45 p.m.
5:30 p.m.
5:15 p.m.
5:00 p.m.
Pee Wee and Midget Game Schedule (subject to change):
Saturdays
August 31
9:00 a.m., 10:40 a.m., 12:50 p.m., 2:30 p.m.
September 7
9:00 a.m., 10:40 a.m., 12:50 p.m., 2:30 p.m.
September 14
9:00 a.m., 10:40 a.m., 12:50 p.m., 2:30 p.m.
September 21
9:00 a.m., 10:40 a.m., 12:50 p.m., 2:30 p.m.
September 28
9:00 a.m., 10:40 a.m., 12:50 p.m., 2:30 p.m.
October 5
9:00 a.m., 10:40 a.m., 12:50 p.m., 2:30 p.m.
October 19
8:55 a.m., 10:38 a.m., 12:21 p.m., 2:04 p.m., 3:47 p.m.
Pee Wee and Midget Awards night is Monday, October 28
Equipment Turn In 6:30 p.m. - 7:00 p.m.
Awards Program 7:00 p.m. - 8:30 p.m.
Snacks after the Program
13 Mailing.05.06 - Program Schedule.docx
State College Assembly of God - Boys Developmental Football Program – Fall Registration Form page 1 - 2013
This form may be duplicated for additional applications. Any changes made to original form will void application.
1. REGISTRATION APPLICATION
Boy's Name ________________________________________________________________________
Last name
Home phone (
First name
Birth Date _______________________
Middle initial
) ________________________________________
month/day/year
Email __________________________________________________
Home Address __________________________________________________________________________________________________________
Street
City
______________________
________
Father's/guardian's last name
______________
)
__
_____
Cell phone
_______
________
Mother's/guardian's last name
Age of Son on 08/01/13: __________
(
First name
State
_
(
First name
)
__
_____
)
__
___
(
)
_
_
Home phone
Program Division: _________________________________
must be filled out
Grade (Fall 2013): __________________
(
Home phone
Cell phone
Son's Registration Weight: ____________
Zip
Flag or Pee Wee or Midget
School (Fall 2013): _________________________________________________
Has he ever played organized contact football previously? _____ yes _____ no
Flag Football ______ yes ______ no
If yes, then when and where: _______________________________________________________________________________________________
I _______________________________________________ being the legal guardian/parent of said person above, have honestly completed this application form and
have answered the questions to the best of my ability. My son(s) and I are willing to abide by the guidelines of the State College Assembly of God Boys
Developmental Football Program.
________________________________________________________
Signature of Parent/Legal Guardian
__________________________
Date
2. PARTICIPANT/PARENT/GUARDIAN WAIVER AND INDEMNITY AGREEMENT
In consideration of your accepting me or my son for participation in the above named program, activity, sport, I hereby, for myself, my heirs, executors, and
administrators, waive and release all rights and claims for damages that I may have against the above-named organization and its agents, employees, representatives,
successors and assigns for any and all injuries suffered by myself or my child that arise out of the above-named program, activity, or sport sponsored by the abovenamed organization.
I warrant that I have the right to authorize the foregoing and do hereby agree to hold the above-named organization harmless of and from any and all liability of
whatever nature that may arise out of or result from such participation.
For the consideration stated above, I further agree that in the event that my son or I should make any claim against the above-named organization for damages
arising out of the above-named program, activity, or sport, I will personally indemnify, defend, and hold harmless the organization and its agents, employees,
representatives, successors, and assigns against any and all loss and damage occasioned thereby, including attorney's fees.
I will provide a copy of my family medical insurance which is to be used in case of injury or illness.
I agree that the above named program’s football equipment will only be used in the above named program.
I understand that participation in any other organized full contact football program simultaneously with the above named program will end my participation in the
above named program.
I also consent to photographs and/or video images of the above listed participant for use within the scope of State College Assembly of God football
program advertisements and brochures.
I have read and understand this Agreement and have willingly placed my signature below as evidence of my acceptance of all the conditions contained
herein.
________________________________________________________
__________________________
Signature of Parent/Legal Guardian
Date
3. REGISTRATION FEE (There will be no refunds after the Skills Days on July 26-27, 2013 if placed on a team)
Pee Wee (PW) & Midget (M) - JUNE 2, 2013 or later:
1 SON = [ ]$80
or
2 SONS = [ ]$140
or
3 or more SONS = [ ]$195
Pee Wee (PW) & Midget (M) - JUNE 1, 2013 or before:
1 SON = [ ]$70
or
2 SONS = [ ]$120
or
3 or more SONS = [ ]$165
Flag (F) - JUNE 2, 2013 or later:
1 SON = [ ]$60 or 2 SONS = [ ]$110
Flag (F) - JUNE 1, 2013 or before:
1 SON = [ ]$50 or 2 SONS = [ ]$90
JUNE 2, 2013 or later:
1F+1PW/M = [ ]$125
or
2F+1PW/M = [ ]$170
or
1F+2PW/M = [ ]$180
JUNE 1, 2013 or before:
1F+1PW/M = [ ]$105
or
2F+1PW/M = [ ]$150
or
1F+2PW/M = [ ]$165
Date _____________ Cash $__________ Check $__________ # __________ Received By: _________________________
State College Assembly of God - Boys Developmental Football Program – Fall Registration Form page 2 - 2013
This form may be duplicated for additional applications. Any changes made to original form will void application.
4. EMERGENCY HEALTH FORM AND MEDICAL RECORD
Family medical insurance must be used during illness or injury requiring treatment, hospitalization, and/or surgery. Please fill out the following medical information
about your son that might affect either his abilities on the field or information that you feel coaches may need to know in case of an emergency.
Boys Name: ______________________________________________ Last Tetanus Toxoid Immunization _________________________________
Date
Local Physician to contact in an emergency: __________________________________________________________________________________
Phone Number: __________________________________
Personal health / accident insurance carrier ________________________________________________ Policy No. __________________________
Does your son wear either glasses or contact lenses? Yes No (Circle One)
If yes, any special restrictions?___________________________________________________________________________________________
______________________________________________________________________________________________________________________
Does your son have any hearing problems or loss? Yes No (Circle One)
If yes, please specify? __________________________________________________________________________________________________
______________________________________________________________________________________________________________________
Does your son have any allergies (bee stings, etc.) or asthma? Yes No (Circle One)
If yes, please specify? __________________________________________________________________________________________________
______________________________________________________________________________________________________________________
Does your son take any regular medications that might be affected by emergency treatment? Yes No (Circle One)
If yes, please specify? __________________________________________________________________________________________________
______________________________________________________________________________________________________________________
Does your son have any other medical conditions that might affect his play on the field or during treatment in an emergency situation?
Yes No (Circle One)
If yes, please specify? __________________________________________________________________________________________________
______________________________________________________________________________________________________________________
In the event of illness or injury during the course of the Football Program, I request that measures be instituted without delay as judgment of medical
personnel dictates. In case of emergency, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my
permission to the athletic trainer and/or medical professional selected by the adult in charge to secure proper treatment, including emergency room
care and/or hospitalization. In the event of illness or injury requiring medical attention at a medical facility or office, regardless of place or
activity of the illness or injury (football or non-football, illness or injury), I understand that a "fit for play" statement will be required from
the medical professional of my choosing to allow continued participation.
________________________________________________________________
__________________
Signature of Parent/Legal Guardian
Date
5. PHYSICIAN'S STATEMENT OF FITNESS TO PLAY - MUST SIGN THIS FORM (NO OTHER FORMS WILL BE ACCEPTABLE)
I,
_________________________________________________________________________________
being the physician, physician's assistant
Print Physician's, Physician's Assistant or Certified Nurse Practitioner's name
or certified nurse practitioner of ________________________________________________________ , have concluded after physical examination
Print Player's name
that he is able to participate in the State College Assembly of God Boys Developmental Football Program in the Fall of 2013.
Date of most recent physical _________________________________________ (must be within 1 year of Physician, PA-C or CRNP’s signature).
_________________________________________________________________
_________________
Physician's, Physician's Assistant or Certified Nurse Practitioner's Signature
6. COPY OF MEDICAL INSURANCE IS ATTACHED (FRONT AND BACK OF CARD)
13 Mailing.07.08 - Program Registration Form.doc
Date
State College Assembly of God - Boys Developmental Football Program - 2013
Participants Code of Conduct
1. I understand that this football program is to share the game of football with boys, develop basic football skills and
have fun. It is a game played by boys. The objective of winning helps to make the program fun, but is it not
considered important in an ultimate sense, particularly at this stage of development. The main purpose is
character development in a Christian setting.
2. I understand that as a player/parent/guardian/coach involved in this football program, my responsibility is to
encourage all of the players to have fun, develop basic football skills, and above all be an example of good
sportsmanship and fair play. This program is for the State College and surrounding communities to encourage all
boys, including the ones on other teams in the program.
3. I understand the importance of supporting the coaches and volunteers who make this program possible. I know
that if I have a legitimate issue that I should discuss it privately with the head coach of my team, even if my issue
is with that coach. If the issue is still a concern then I should discuss it privately with the Program Director, then
the overseeing Pastor.
4. I understand as a participant I must set the proper example for the players and other families and abide by the
program rules of behavior for coaches, players, parents and spectators, and that the following actions are NOT
ACCEPTABLE:
a.
b.
c.
d.
e.
negative comments directed at any players, coaches, game officials, spectators
criticism of game officials
profane language
physical confrontations (pushing, hitting, etc.)
use of alcohol and tobacco
5. I understand that if I display improper behavior I may be asked to leave the premises and if the transgressions are
repeated or serious enough, I may be prohibited from attending any and all program activities.
6. Finally, I understand that if we all help out as much as possible, support our fellow players (all of the boys) and
create a positive, enjoyable environment, we can look forward to a great season.
I have read, understand (parents may need to help your player with this) and will abide by this participants code of
conduct agreement:
Player: _______________________________________________
Date: _____________________
Parent/Guardian: ______________________________________
Date: _____________________
Parent/Guardian: ______________________________________
Date: _____________________
13 Mailing.09 – Code of Conduct.doc
FALL PROGRAM:
“ONLY FULL REGISTRATIONS WILL BE ACCEPTED”
WHAT DOES THAT MEAN?????
Here is a checklist to help you out:
[ ]
Registration Form
Form is filled out with parental/guardian signatures in all the right places, registration weight, grade, age, birth
date, health history, etc.
[ ]
Doctor’s Signature
“have concluded after physical examination that he is able to participate in the State College Assembly of God
Boys Developmental Football Program in the Fall of 2013” Every year this is a struggle to get this done.
TODAY is the day to make that phone call. Set it up now. Contact your son’s Medical Professional. Maybe
he/she will sign without having to do a physical. This is solely under the discretion of your son’s Medical
Professional. Yes, your Physician, Physician's Assistant or Certified Nurse Practitioner MUST sign our form - No
other forms will be accepted. Best advice: DON’T WAIT!
[ ]
Copy of Medical Insurance Card
You will need to show proof of medical insurance by supplying a photocopy of your insurance card (FRONT
AND BACK). If you register in person at the Church office, the ladies can copy your card for you.
[ ]
Full Payment of Program Registration Fee
We will give a discount to those who help us out by registering on or before JUNE 1.
Those registering after JUNE 1 will pay the full program fee.
[ ]
Participants Code of Conduct
Must be signed and attached to form.
[ ]
What if I am early or late?
“Early”: Registration packets are now being accepted. We guarantee a spot for every player who registers
by our early registration date of JUNE 1.
“Late”: Late could be any time after JUNE 1. In years past we have had to close out program divisions, which
filled up. Best bet is to get it done by JUNE 1.
Partial Registrations (those missing any of the above) will not be accepted.
John Potter
Program Director
13Mailing.10 - Full Registration.doc
STATE COLLEGE ASSEMBLY OF GOD
BOYS DEVELOPMENTAL FOOTBALL PROGRAM
2201 University Drive Extension, State College, PA 16801
Phone: 238-3800, Fax: 238-5430
website: http://www.scassembly.org/football
email: [email protected]
txt messaging: http://trunc.us/fNUh13 to sign up
Spring MNF, Summer Camp, Fall Program
2013 BACKGROUND CHECK POLICY:
Name __________________________________________________ Email _____________________________________________
Address ___________________________________________________________________________________________________
Home Phone _________________________________________ Cell Phone _____________________________________________
My Football Player(s) is (are) ________________________________________________ Program Division ___________________
COACHES and ALL other adults participating with the players must be able to secure three clearances administered by
Protect My Ministry. State College Assembly of God Boys Developmental Football Program (SCAofG Football) requires you to
electronically submit background requests to Protect My Ministry, by visiting www.scassembly.org/football to link to their website.
Info required online will include name, address, phone, birth date, social security number and address history.
State College Assembly of God is committed to providing a safe and secure environment for those who participate in our programs.
To minimize any vulnerability to children and youth, as well as minimize unwarranted accusations of improper behavior that our
church volunteers and employees may experience in our ministries, we have some requirements for adults involved in children and
youth ministry.
To fulfill these commitments as fully as possible State College Assembly of God has adopted the following procedures to be used,
without exception, when selecting SCAofG Football Coaches and all other adults participating with the players.
1. Complete a State College Assembly of God Boys Developmental Football Program Coaches application
2. Three background clearance checks:
a. Social Security Number Verification and Address History Trace
b. National Criminal Database Search
c. National Sex Offender Registry Search
3. Volunteers will be re-screened at regular intervals to ensure a safe and secure environment for children and youth
participating in State College Assembly of God ministry programs.
4. Volunteers will complete online Child Safety Training - Abuse Awareness and Prevention prior to participation – a 90
minute self-paced training program
Privacy Statement
Protect My Ministry, a secure organization licensed to conduct background checks, is the only party that will see a social security
number (SSN). A SSN will be used only to run an identity and address verification check. Rest assured that your privacy and identity
are protected.
From Protect My Ministry's webpage [http://protectmyministry.com]: "Protect My Ministry background checks are performed on
secure sites and the online systems are tucked away in secure servers and locations with offsite backups. Protect My Ministry is a
Christian-owned and operated business."
In other words, applications will always reside on Protect My Ministry's servers - it will never reside on State College Assembly of
God equipment. Your SSN will show as: * to State College Assembly of God when your application is viewed and as XX-XX-(last
four digits) on the clearance records.
2013 I CAN HELP WITH THE FOLLOWING:
____ OPEN HOUSES – set-up, greet people, share program vision/goals
____ SPRING Monday Night Football – assist high school / college age young men with teams
____ SPRING Monday Night Football – concessions
_____ SPRING Monday Night Football – facilities/support
____ COMMUNITY CLEAT SWAP – July 9 and at Summer Camp
____ SUMMER CAMP – teach skills
____ SUMMER CAMP – concessions
____ SUMMER CAMP – facilities/support
FALL PROGRAM
FLAG – we need 8 head coaches and 16 assistants and helpers and 8 team parents
____ Head Coach
____ Assistant Coach
____ Helper
____ Team Parent
PEE WEE – we need 6 head coaches and 12 assistants and helpers and 6 team parents
____ Head Coach
____ Assistant Coach
____ Helper
____ Team Parent
MIDGET – we need 4 head coaches and 8 assistants and helpers and 4 team parents
____ Head Coach
____ Assistant Coach
____ Helper
____ Team Parent
NOTE: Coaches in the Fall Program will need to complete a USA Football Coaching Education course to participate (in addition to
the Protect My Ministry Background Checks).
Team Parent coordinates: team phone tree, emails, picture forms, hoagie/pizza sale forms, scoreboard operators, down marker &
chains, picture hand-outs, hoagie/pizza sorting day volunteers, hoagie/pizza sale money collection, team snacks, team parties, etc.
___ TUESDAY night Concessions Coordinator – 8 Tuesday nights during flag football practices & games
___ WEDNESDAY night Concessions Coordinator – 7 Wednesday nights during flag football skills practices
___ THURSDAY night Concessions Coordinator – 6 Thursday nights during flag football games
___ FRIDAY night Concessions Coordinator – 6 Friday nights during pee wee and midget games
___ CONCESSIONS STAND – donations, homemade baked goods, foods
___ LOST & FOUND COORDINATOR – gather items, give out items, table at both awards nights, dispose of what is left
___ HOAGIE/PIZZA SALE – set-up, sorting, tear-down
___ SCOREBOARD OPERATOR – HOME TEAM – your team parent will have a sign-up sheet
___ DOWN MARKER & CHAINS – VISITING TEAM – your team parent will have a sign-up sheet
___ FLAG AWARDS NIGHT – video/slide show
___ PEE WEE & MIDGET AWARDS NIGHT – video/slide show
___ BOWL GAME COORDINATOR
___ BOWL GAMES
___ GAME OFFICIAL (PIAA CERTIFIED)
___ GAME OFFICIAL – 14 yrs old or older
13Mailing.11.12 – Vounteer.doc
STATE COLLEGE ASSEMBLY OF GOD
SPRING MNF FOOTBALL PROGRAM
2201 University Drive Extension, State College, PA 16801
Phone: 238-3800, Fax: 238-5430
website: http://www.scassembly.org/football email: [email protected]
txt messaging: http://trunc.us/fNUh13 to sign up
Monday Night Football Director: John Potter, Football Program Director
What to Wear: Shorts, T-Shirt, Cleats
Cost (Note there are no refunds once signed up): $25
Includes MNF t-shirt
Schedule: 5:30 - 8:00 pm each night for 9-13 yr olds
5:30 - 7:30 pm for 6-8 yr olds
Dates:
April 15 May 13
April 22 May 20
April 29 June 3
May 6
June 10
About MONDAY NIGHT FOOTBALL:
Monday Night Football is an 8-week spring football program open to any boy ages 6-13. Each evening will start with
warm-up/stretch/flexibility/football exercises. We will be blessed to have One On One Fitness in State College do a
planned progressive football exercise program with our players. A special guest each night will present a mini-clinic
on a specific football skill. Teams by age will be selected each night; a short practice time; and then flag football
games will complete the evening. 12-13 yr olds will participate in a seven-on-seven passing game each week. A halftime talk will include an applicable devotion to everyday life and prayer.
MNF PARTNERS:
Where:
State College Assembly of God Football Fields at 2201 University Drive Extension in State College.
******************************************************************************************************************************
REGISTRATION AND EMERGENCY MEDICAL INFORMATION – 2013 MONDAY NIGHT FOOTBALL
_____________________________________________________________________________________
Last name
First name
Middle initial
Home phone (
) __________________________________________
Age (on 08/01/13) _______________
Grade (Fall 2013): ___________
Birth Date: __________________
month/day/year
Home Address ___________________________________________________________________________________________________________________
Street
City
State
Zip
_________
Cell phone (
) ______________________________________
Parent's/guardian's names (please print)
Email (s): ___________________________________________________________ ___________________________________________________________
Family medical insurance must be used during illness or injury requiring treatment, hospitalization, and/or surgery. In the event of illness or injury
during the course of the Monday Night Football in 2013, I request that measures be instituted without delay as judgment of medical personnel dictates. In case of
emergency, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the athletic trainer and/or
medical professional selected by the adult in charge to secure proper treatment, including emergency room care and/or hospitalization. I also consent to
photographs and/or video images of the above listed participant for use within the scope of State College Assembly of God football program advertisements and
brochures.
Local Physician to contact in an emergency: ___________________________________________________ Phone: _______________________________
Personal health / accident insurance carrier __________________________________________ Policy No. _______________________________________
_____________________________________________________________________
Signature of Parent/Legal Guardian
Date Paid _____________
Cash $________
Check $________ # ________
(Non-refundable)
__________________________
Date
13 Mailing.13 – Monday Night Football.doc
STATE COLLEGE ASSEMBLY OF GOD
BOYS DEVELOPMENTAL FOOTBALL PROGRAM
2201 University Drive Extension, State College, PA 16801
Phone: 238-3800, Fax: 238-5430
website: http://www.scassembly.org/football
email: [email protected]
txt messaging: http://trunc.us/fNUh13 to sign up
Spring MNF, Summer Camp, Fall Program
Ninth Annual
COMMUNITY CLEAT SWAP
Football/Soccer/Baseball/All Sports
July 9 – 5:30 – 7:30 PM
State College Assembly of God Boys Developmental Football Program will be
holding a Community Cleat Swap on Tuesday, July 9 from 5:30 – 7:30 pm at 2201
University Drive Ext. Bring your football, soccer, baseball, all sports cleats that do
not fit and swap for a pair that do. Our Community Cleat Swap Sponsor,
BALFURD CLEANERS, has cleaned OVER 50 pairs of good used cleats for
swapping.
We continue to accept donations of used and new cleats for the swap. Drop them
off or call for a pick up.
If you do not have a pair to swap: With a donation of $5.00 (or more if you want
to) pickup a pair. This donation goes toward larger sizes and common sizes. Most
new cleats run between $30 and $50. There is no guarantee of your size, however,
we will do our best to help all participants.
Community Cleat Swap Sponsor
13 Mailing.14 – Cleat Swap.doc
STATE COLLEGE ASSEMBLY OF GOD
FOOTBALL SUMMER CAMP
2201 University Drive Extension, State College, PA 16801
Phone: 238-3800, Fax: 238-5430
website: http://www.scassembly.org/football
email: [email protected]
txt messaging: http://trunc.us/fNUh13 to sign up
2013 Football Summer Camp – July 22-25
for Boys ages 6-13
Camp Director:
John Potter, Football Program Director
Cost (Note there are no refunds once signed up):
$45 if you register after JUNE 1 or at camp
$30 if you register on or before JUNE 1 ($15 discount)
Includes a Camp Shirt
What to Wear:
Shorts, T-Shirt, Cleats
About the Camp:
The State College Assembly of God Football Camp is open to any boy ages 6-13. Boys who are participating in a Fall Football Program are
encouraged to attend (you do not have to be a part of our program to attend). In the past 15 years we have had many local college coaches and
players visit our camp as special guests to share their love of football and speak with our campers. Local inter-scholastic coaches and players
assist our USA Football certified coaching staff in teaching skills. Boys at all skill levels will learn - no prior Football experience is needed.
We will be blessed to have One On One Fitness in State College do a planned progressive football exercise program with our players. The first
three nights will be dedicated to a team skill (offense, defense, and special teams). Individual skills such as stance, blocking, tackling, running,
throwing, catching, kicking, receiving, coverage, etc. will be taught. Both small group and one on one instruction will be highlighted.
Wednesday night will feature the QB Challenge, Punt/Pass/Kick and 40 yd dash competitions. Thursday night will be flag football games night.
In addition to prayer and devotions, the program will highlight a special guest speaker each night who will share how the skills learned in
Football relate to every day life.
What, When and Where:
The Camp will be at the State College Assembly of God Football Fields at 2201 University Drive Extension in State College. Monday thru
Thursday, July 22-25, from 5:30 p.m. - 8:30 p.m. each day. Show up at 5:00 p.m. - 5:15 p.m. for nightly sign-in.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------2013 SUMMER FOOTBALL CAMP - REGISTRATION AND EMERGENCY MEDICAL INFORMATION
______________________________________________________________________________________
Last name
First name
Middle initial
Home phone (
) __________________________________________
Age (on 08/01/13) _______________
Grade (Fall 2013): ___________
Birth Date: __________________
month/day/year
Home Address ____________________________________________________________________________________________________________________
Street
City
State
Zip
_________
Cell phone (
) _______________________________________
Parent's/guardian's names (please print)
Email (s): ___________________________________________________________ ___________________________________________________________
Family medical insurance must be used during illness or injury requiring treatment, hospitalization, and/or surgery. In the event of illness or injury
during the course of the Football Summer Camp on July 22-25, I request that measures be instituted without delay as judgment of medical personnel dictates. In
case of emergency, I understand every effort will be made to contact me. In the event I cannot be reached, I hereby give my permission to the athletic trainer
and/or medical professional selected by the adult in charge to secure proper treatment, including emergency room care and/or hospitalization. I also consent to
photographs and/or video images of the above listed participant for use within the scope of State College Assembly of God football program advertisements and
brochures.
Local Physician to contact in an emergency: ___________________________________________________ Phone: _______________________________
Personal health / accident insurance carrier __________________________________________ Policy No. _______________________________________
_____________________________________________________________________
Signature of Parent/Legal Guardian
Date Paid _____________
Cash $________
Check $________ # ________
(Non-Refundable)
__________________________
Date
13 Mailing.15 – Camp Registration Form.doc