PLAYER & PARENT AGREEMENTS
Liability Waiver
By registering my son/daughter(s) with Park City Water Polo, I agree to allow my son/daughter to
participate in Park City Water Polo, and hereby release Park City Water Polo/Park City Aquatic Center/
Park City School District, its directors, officers, agents, coaches, and employees from liability for any injury
that might occur to myself (or to my son/daughter(s) and family members while participating in the Park
City Water Polo program, including travel to and from training sessions, games or other scheduled team
activities.
I agree to indemnify and hold harmless the above mentioned organizations and/or individuals, their agents
and/or employees, against any and all liability for personal injury, including injuries resulting in death to
me, my son/daughter(s) and/or other family members, or damage to my property, the property to my son/
daughter(s) and/or other family members, or both, while I or my son/daughter(s) or family members
participating in the Park City Water Polo program.
Medical Release Waiver
I certify that I am the parent or legal guardian for my son/daughter(s). I hereby give my permission for any
supervisor, coach or other team administrator associated with Park City Water Polo to seek and give
appropriate medical attention for my son/daughter(s) in the event of accident, injury, illness. I will be
responsible for any and all costs associated with any necessary medical attention and/or treatment.
I hereby waive, release and forever discharge Park City Water Polo/Park City Aquatic Center/Park City
School District and associated supervisor, coach or other team administrator from all rights and claims for
damages, injury, loss to person or property which may be sustained or occur during participation in Park City
Water Polo activities, whether or not damages or loss is due to negligence. I hereby acknowledge that my
son/daughter(s) is (are) physically fit and capable of participation in all water polo activities.
Requirements and Obligations
I understand that if my player does not meet the attendance requirement, they may not be allowed
to play in a game and will be placed on the bench.
• I understand that if my child takes a leave of absence or discontinues participation from Park City
Water Polo that I am obligated to pay any outstanding fees owed Park City Water Polo. Notification
of any absence or departure must go to the Park City Water Polo Admin or Head Coach. • I understand that there will be NO REFUNDS or credits given for any period of time where player(s)
did not participate with Park City Water Polo. (Extreme circumstances will be taken into
consideration.)
• I understand that if a player leaves Park City Water Polo after the first month that there will be no
fees refunded.
I have read the above Liability Release, Medical Waiver, and Requirements and Obligations and agree to
abide by the above policies.
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___________________________
Parent Printed Name/Signature
___________
Date
_____________________________________
Player’s Name
PARK CITY WATER POLO ATHLETE MEMBER HONOR CODE
An Athlete Member is an individual who participates in the sport of water polo and is in good standing as an
individual member of Park City Water Polo and USA Water Polo.
Park City Water Polo athlete members will:
• Value the opportunity to be a member of Park City Water Polo.
• Act and behave in a way that positively reflects upon Park City Water Polo and its members.
• Display proper respect and sportsmanship toward all coaches, officials, administrators, teammates,
competitors and the public at all times.
• Treat our facility with care and appreciation.
• Wear a team suit at all Park City Water Polo games. Any player not wearing a team suit at games will
be placed on the bench for the entire game.
• Be honest and fair in all dealing and interactions with others.
• Value the rights, dignity and self worth of all others.
• Abide the USA Water Polo Athlete Code of Conduct.
• Be a positive role model.
• Accept the responsibility of your actions.
• Be aware of and adhere to Park City Water Polo standards, rules, regulations and policies.
• Refrain from using inappropriate language.
• Refrain from any inappropriate or illegal behavior that would detract from Park City Water Polo,
PCAC, PCSD or its sponsors.
• Refrain from any form of harassment towards others.
• Refrain from any form of discrimination towards others.
• Refrain from any form of abuse (physical, verbal, emotional, etc) towards others.
• Refrain from any form of theft or robbery.
• Refrain from the possession, use or sale of any type of illegal substance (tobacco, drugs, alcohol,
etc).
• Refrain from engaging in inappropriate physical or sexual conduct.
• Refrain from possessing or distributing explicit or pornographic materials.
• Refrain from using, exhibiting or possessing weapons.
• Immediately report any violations of the Park City Water Polo Honor Code to the appropriate
authority.
• Understand that not reporting a violation of the Park City Water Polo Honor Code may be considered
as participation in the violation of the honor code.
• Understand the possible consequence of breaking the Park City Water Polo Honor Code.
In addition to actions listed above, Park City Water Polo athlete members while participating in team
activities and/or travel trips will:
• Refrain from any act which would be considered an offense under federal, state, local or USOC laws
or rules.
• Respect all properties (hotel room, restaurant, vehicles, venues, etc.) Any physical damage
occurring to said properties shall be paid for by participants involved with the occurrence.
Disciplinary Actions
Failure to comply with the Park City Water Polo Honor Code as set forth in this document may result in
disciplinary action. Such discipline may include, but may not be limited to:
• Dismissal from the current team function.
• Suspension from team functions (including practices, water polo games and activities).
• Dismissal from a travel trip. Dismissed athlete member may be immediately sent home at their own
expense. Athletes dismissed from a travel trip will be held financially responsible for the total cost
of the trip as well as the return trip.
• Financial penalties.
• Suspension of future travel privileges with Park City Water Polo, Utah Water Polo and USA Water Polo.
• Board of Review Proceedings from Utah Water Polo and/or USA Water Polo.
•
Dismissal from Park City Water Polo - Dismissed players are responsible for finalizing the members
account and understand that no refunds or reimbursements will apply in case of dismissal from the
team.
Park City Water Polo Athlete Member
I acknowledge that I have read, understand and agree to abide by the Park City Water Polo Athlete Member
Honor Code.
_________________________
Athlete Printed Name
_________________________
Athlete
Signature
___________
Date
Parent/Guardian of Park City Water Polo Athlete Member
I, the parent/guardian of the above mention athlete member, acknowledge and agree that I that I have read
and understand the Park City Water Polo Athlete Honor Code. I agree that my athlete member will abide by
the Honor Code.
_________________________
Parent/Guardian Printed Name
_________________________
Parent/Guardian Signature
___________
Date
PARK CITY WATER POLO PARENT HONOR CODE
As a parent/guardian of an athlete member of Park City Water Polo, I agree that I will abide by the following
guidelines:
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I will embrace and support the Mission, Vision, Values and Beliefs of Park City Water Polo.
I will be my player’s biggest fan and provide unconditional encouragement, support and empathy.
I realize that player’s become easily confused when coached by a parent and benefit most from
positive reinforcement of the professional coaching staff’s instruction and advice.
I understand that I am an example for my player and should always promote good sportsmanship.
I am proud to be a member of Park City Water Polo and support the players, coaches and team with
positive actions.
I understand that if I have a question or concern that needs to be addressed with a coach and/or
team administration that I will approach the situation in a respectful and appropriate manner. I
understand that on deck during practice or at a water polo game is not the appropriate time or
place, and that I should make an appointment to address the situation with the appropriate
personnel.
I understand that criticizing, name calling, use of abusive/profane language or gestures directed
toward any player, coach, official, administrator and game personnel will not be permitted nor
tolerated.
Violation of the above may result in suspension or termination from Park City Water Polo or USA
Water Polo. Should I conduct myself in such a way that brings discredit or discord to Park City Water
Polo, I voluntarily subject myself to disciplinary action. I understand that Park City Water Polo
maintains the right to terminate any membership privilege with cause in the interest of the team’s
vision, mission and objectives.
_________________________
Parent/Guardian Printed Name
_________________________
Parent/Guardian Signature
_________________
Date