tournament packet - SCMAF

February 18, 2013
Dear S.C.M.A.F. Bay Area and South East Participants:
We are rapidly approaching the 2013 S.C.M.A.F Bay Area South East Youth Basketball Tournament
of League Champions. The tournament will be held on March 22 (Boys Division C only), March 23,
2013 (and March 24 if needed) in the cities listed below. This tournament is strictly for teams
participating in your recreation league. In this packet you have been provided with an Entry form,
Minor Release form (English & Spanish), Age Division breakdown and the Team roster.
All of your league teams must be registered with the SCMAF office to be eligible to participate for
this tournament. All league rosters must also be submitted to the SCMAF office. Cost to register
teams with the SCMAF office is $3 per team.
Entry forms will be due to their respective host cities by Monday, March 18, 2013 no later than 5:00
p.m. Rosters, waivers and proof of age are due 30 minutes before your first scheduled game. The
entry fee per team is $150.00 which can be paid at the tournament OR your agency can be billed.
Please make checks payable to: SCMAF Southeast.
Tournament brackets will be emailed to each team representative no later than March 20, 2013 at
5:00 p.m.
Please fax or mail entry forms to the corresponding cities listed below. Please call to verify that your
forms were received.
Boys Division “A” Boys Division “B” Boys Division “C”
City of Lynwood City of Inglewood City of Pico Rivera
Nyla Glennn Mike Davis Stephanie Zamora
(323) 886-0426 (310) 412-5370 (562) 801-4454
Fax: (310) 637-7784 Fax: (310) 412-8792 FAX: (562) 942-2562
nglenn@lynwood.ca.us mdavis@cityofinglewood.org szamora@pico-rivera.org
Girl’s Division “A” Girl’s Division “B” Girl’s Division “C”
City of Huntington Park City of Downey City of Bell Gardens
Gustavo Hernandez Kevin Ellis Armando Andrade
(323) 584-6218 (562) 869-4738 (562) 806-7650
Fax: (323) 584-6310 Fax: (562) 904-7296 Fax: (562) 776-9406
ghernandez@huntingtonpark.org kellies@downeyca.org aandrade@bellgardens.org
We hope to see teams representing your agency this year. For questions, please contact each site
representative or send an email to southeast@scmaf.org
Sincerely,
SCMAF Bay Area and South East

**INSTRUCTIONS**
Completed registration packets must include:
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Event Entry Form
Fax or e-mail to each corresponding city by March 18, 2013 no
later than 5 p.m.
SCMAF Minor Release and Consent for Treatment Forms
Completed and signed by parent or guardian for all players on
team roster. (Will be checked-off on team roster by host city staff
30 minutes prior to your first scheduled game)
Proof of Age
For all players on team roster. Copies only. (Will be checked-off
on team roster by host city staff 30 minutes prior to your first
scheduled game)
Proof of Grade
For all provisional players (Will be checked-off on team roster by
host city staff 30 minutes prior to your first scheduled game - see
Youth Basketball Rule Book for more details).
Youth Basketball Official Roster
Completed and signed by head coach due 30 minutes prior to your
first scheduled game.
**IMPORTANT**
All teams that wish to participate in any
ASSOCIATION Tournaments must be registered with
SCMAF before participating in the Association
Tournaments.

2013 COMPETITION DIVISIONS
AGE - The year born is the primary criteria for determining the age for competition. Players must provide
written verification of date of birth. Special provision players using grade for the division must provide
written verification of current grade.
DIVISIONS - The following divisions shall be used for all SCMAF Basketball competitions:
Division AA - Open Division Only - Born in 1997 or 1998
Players who are born in 1997 or 1998 and players born in 1996 and in a grade no higher than 10th are
eligible.
Division A - TLC/Open Divisions - Born in 1999 or 2000
Players who are born in 1999 or 2000 and players born in 1998 and in a grade no higher than 8th are
eligible.
Division B - TLC/Open Divisions - Born in 2001 or 2002
Players who are born in 2001 or 2002 and players born in 2000 and in a grade no higher than 6th are
eligible.
Division C - TLC/Open Divisions - Born in 2003 or 2004
Players who are born in 2003 or 2004 and players born in 2002 and in a grade no higher than 4th are
eligible.

PLEASE PRINT
CHILD’S NAME:
SOUTHERN CALIFORNIA MUNICIPAL ATHLETIC FEDERATION
(SCMAF)
MINOR RELEASE FORM AND CONSENT FOR TREATMENT
First
Last
MALE FEMALE AGE DATE OF BIRTH: / /
NAME OF PARENT OR GUARDIAN: _______________________________________________________________________
First
Last
ADDRESS: ____________________________________________________________________________________________
City State Zip
HOME PHONE: __________________________________ BUSINESS PHONE: ___________________________________
ACTIVITY: ___________________________________________________________________________
RELEASE
I give permission for the minor in my custody to participate in the above-mentioned activity and hereby waive, release and
discharge any and all claims or rights to claims for damages for death, personal injury or property damage which I may
have, or accrue to me, as a result of said minor’s participation in said activity. This Release is intended to discharge in
advance the promoters, sponsors, the Southern California Municipal Athletic Federation (SCMAF), the officials, and any
involved municipalities or other public entities (and their respective agents and employees), from and against any and all
liability arising out of or connected in any way with said minor’s participation in said activity, even though that liability may
arise out of negligence or carelessness on the part of the persons or entities mentioned above.
I further understand that serious accidents occasionally occur during said activity, and that participants in such activity
occasionally sustain mortal or serious personal injuries, and/or property damages, as a consequence thereof. Knowing
the risks of said activity, nevertheless, on behalf of said minor child, I hereby agree to assume those risks and to release
and hold harmless all of the persons or entities mentioned above who, through negligence or carelessness, might
otherwise be liable to me, or my heirs or assigns for damages.
It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs and
assigns. It is further understood and agreed that this waiver, release and assumption of risk is to be binding on my heirs
and assigns.
I agree to accept and abide by the rules and regulations of the Southern California Municipal Athletic Federation.
Date
Signature of parent or guardian
CONSENT TO TREATMENT OF MINOR
*In the event of sudden illness, accident or injury which may occur while said minor is engaged in an activity supervised by
the Southern California Municipal Athletic Federation and their representatives, agents or assignees, when neither the
parents, guardian or designated family physician can be contacted, I hereby give my consent pursuant to California Civil
Code #25.8 for emergency treatment as shall be necessary under the circumstances by any physician licensed under the
Laws of the State of California.
Date
Family Physician:
Insurance Co.:
Signature of parent or guardian
Pertinent medical history information (Epilepsy, Diabetes, Allergies, etc.)
Telephone:
Type of Coverage:
Emergency Numbers: 1. Name
Phone:
(other than parents) 2. Name Phone:

NOMBRE DEL MENOR:
Nombre
SOUTHERN CALIFORNIA MUNICIPAL ATHLETIC FEDERATION
(SCMAF)
SIRVASE COMPLETAR LA INFORMATION CON LETRA DE IMPRENTA
FORMULARIO DE DESCARGO DE RESPONSABILIDAD Y DE
CONSENTIMIENTO PARA RECIBIR TRATAMIENTO
Apellido
HOMBRE MUJER EDAD FECHA DE NACIMIENTO: / /
NOMBRE DEL PADRE/MADRE O TUTOR:
Nombre
Apellido
DOMICILIO: _____________________________________________________________________________
Ciudad
Código Postal
NO. DE TEL./HOGAR: _______________________ NO. DE TEL./TRABAJO: ________________________
ACTIVIDAD: _____________________________________________________________________________
DESCARGO DE RESPONSABILIDAD
Doy permiso, al menor en mi cuidado, de que participe en la antedicha actividat, y por la presente renuncio y descargo cualquier y todo
reclamo or derecho de reclamo por daños y perjuicios causados per muerte, pre lesiones personales o daños a bienes, que pueda
tener, or que puedan, en lo sucesivo, acumulárseme, como resultado de la participación de dicho menor en dicha actividad. Este
descargo de responsabilidad es para liberar de responsabilidad, de antemano a los promovedores, a patrocinadores, a la Federación
Atlética Municipal del Sur de California (SCMAF), a sus funcionarios y a cualquier municipalidad u organismo público (y a sus
respectivos agentes o empleados), que esté involucrado, de y contra cualquier y toda responsabilidad que surja de, o que esté
relacionado, de cualquier manera, con la participación de dicho menor en dicha actividad, aun cuando esta obligación pueda surgir por
negligencia o descuido por parte de las personas u organismos antedichos.
También comprendo que es posible que ocurran accidentes graves durante dicha actividad, y que los que participan en dicha actividad
ocasionalmente sufren lesiones graves o mortales y/o daños a sus bienes, como consecuencia de la misma. Sin embargo,
conociendo los riesgos de dicha actividad, en nombre de dicho menor, por la presente acepto asumir la responsabilidad de estos
riesgos y descargo de responsabilidad a toda persona u organismo, antedicho, quien debido a negligencia o descuido, hubiese sido
responsable ante mi, o ante mis herederos o beneficiarios, por daños.
Queda entendido y acepto que este descargo y asunción de riesgo sea valedero en cuanto a mis herederos y beneficiarios.
Accedo aceptar y cumplir con las reglas y reglamentaciones de la Federación Atlética Municipal del Sur de California.
Fecha
Firma de padre/madre o tutor
CONSENTIMIENTO DE QUE EL MENOR RECIBA TRATAMIENTO
*En caso de cualquier enfermedad repentina, accidente o lesión que pueda ocurrir mientra que el menor esté participando en una
actividad supervisada por la Federación Atlética del Sur de California y sus representantes, agentes o personas designadas,cuando
ninguno de sus padres, su tutor o médico particular, pueda ser ubicado, por la presente doy mi consentimiento, conforme con el
Código Civil de California, No. 25.8, de que se administre tratamiento de emergencia en la medida en que fuese necesario, per parte
de cualquier médico que esté licenciado por las leyes del estado de California.
Fecha
Firma de padre/madre o tutor
Médico de Familia:
Teléfono:
Compañia de Seguro Médico:
Tipo de Póliza:
Antecedentes médicos importantes: (Epilepsia, Diabetis, Alergias, etc.)
Números a los cuales llamar en caso de emergencia: (de personas que no sean los padres)
1. Nombre: Téleono:
2. Nombre: Téleono:
FEDERATION ATLETICA MUNICIPAL DEL SUR DE CALIFORNIA

YOUTH BASKETBALL OFFICIAL ROSTER
AGENCY_______________________________________
TEAM NAME ___________________________________
HEAD COACH __________________________________
ADDRESS . ____________________________________
CITY
ZIP _____________
ASST. COACH _________________________________
ASSOCIATION ________________________________
COLOR OF JERSEY ____________________________
DAY PHONE ( ) _____________________________
EVENING PHONE ( ) ________________________
FAX # ( ) __________________________________
DAY PHONE ( ) ____________________________
FOR OFFICE USE ONLY
PROOF PROOF PROOF
WAIVER OF AGE OF GRADE PLAYER NAME JERSEY # PHONE # BIRTHDATE
MONTH/DAY/YEAR
❒ ❒ ❒ 1.
GRADE
❒ ❒ ❒ 2.
❒ ❒ ❒ 3.
❒ ❒ ❒ 4.
❒ ❒ ❒ 5.
❒ ❒ ❒ 6.
❒ ❒ ❒ 7.
❒ ❒ ❒ 8.
❒ ❒ ❒ 9.
❒ ❒ ❒ 10.
❒ ❒ ❒ 11.
❒ ❒ ❒ 12.
We, the undersigned team coach and SCMAF representative declare that this team meets all SCMAF rules and
regulations as outlined in the Youth Sports Rules Book.
________________________________________ ___________________________________ Date _______________
Head Coach Signature
Print Name
________________________________________ ___________________________________ Date _______________
SCMAF Representative Signature
Print Name
HEAD COACH AND ASSISTANTS CODE OF CONDUCT The administrators, supervisors, and coaches representing the
agencies and associations shall coach and act in a courteous and professional manner while on or off playing area. We, as the head
coach and assistants, agree to support and influence good sportsmanship, high moral standards, and be responsible for the conduct and
acts of our players and spectators.
Head Coach Signature ____________________________ Asst. Coach Signature ____________________________
Asst. Coach Signature ______________________________

Event entry
Dear Agency Representative:
Thank you for your interest and participation in our tournament/event.
Please note that once you have committed your participation, your agency is responsible for any entry fees. Thank you
for your cooperation!
- Southeast Municipal Athletic Association
* PLEASE PRINT THE FOLLOWING INFORMATION *
Participating Agency: ________________________________________________ _
Contact Person: ______________________________________________________
Contact e-mail address:
Billing Address: _________________________________ City: ________________
Zip Code: ___________ Daytime #: _________________ Fax #: _________ _____
EVENT INFORMATION - For team sports, please select the division you would like to
participate in and the number of teams your agency will be entering in each division. For
individual sports, please indicate the estimated number of participants your agency will be
entering.
FOOTBALL
Division A
Division B
Division C
BOYS BASKETBALL
Division A
Division B
Division C
SWIMMING
# of Swimmers
VOLLEYBALL
Division A
Division B
Division C
GIRLS BASKETBALL
Division A
Division B
Division C
DAN ABLOTT SB TOURNAMENT
# of Teams
CROSS COUNTRY
# of Runners
TRACK & FIELD
# of Runners