Mantis Muay Thai

EMERGENCY CONTACT FORM

Name of Participant:  ______________________________

Address of Participant:  ____________________________

Date of Birth:______

Allergies: ________________________________________

Primary Emergency Contact Name:  ___________________

Telephone: ______          

 Telephone: ___

Secondary Emergency Contact Name:  _________________

Telephone: __________             

Telephone: ______ 

Athletic Consent Form

Name of Participant:  __________________________________

Address of Participant:  __________________________________

Name of Organization: Mantis Muay Thai

Address of Organization:  281 Sunset Park Drive Herndon, VA 20170

I, the undersigned, hereby acknowledge that certain risks of injury are inherent to participation in recreational activities and athletic activities. These risks and dangers may be caused by the action, inaction or negligence of the participant or others. There may be other risks not known or reasonably foreseeable at this time.

 I, the undersigned accept and assume such risks and responsibility for the losses and/or damages following such injury, however caused, and whether caused in whole or in part by the negligence of the Participant named above.

I, the undersigned, thoroughly understand the intensity of the given activity. If the above Participant has a temporary restriction (sickness, sprain or soreness) I will inform the appropriate instructor on a daily basis. Having read the above statement I am aware of the inherent risk of injury involved in athletic participation. Finally, I understand that in accepting the risks associated with athletic participation I will also share the responsibility of minimizing those risks.

Date: ___{sign_date}____

This Athletic Consent Form is provided by Francis L. Dean & Associates, Inc., a national provider of sports, leisure and entertainment insurance.  For more information, visit www.fdean.com.

Mantis Muay Thai

Code of Conduct for Participants  

Participation in Mantis Muay Thai should demonstrate high standards of ethics and sportsmanship and promote the development of good character and other important life skills. The highest potential of teamwork is achieved when participants are committed to pursuing success with honor according to six core principles: trustworthiness, respect, responsibility, fairness, caring, and good citizenship (the "Six Principles of Character").

This Code applies to all participants involved in Mantis Muay Thai.

I understand that, in order to participate in Mantis Muay Thai, I must act in accord with the following:  

TRUSTWORTHINESS

1. Trustworthiness — be worthy of trust in all I do.
   • Integrity — live up to high ideals of ethics and sportsmanship and always pursue success with honor; do what’s right even when it’s unpopular or personally costly.
   • Honesty — live and compete honorably; don’t lie, cheat, steal, or engage in any other dishonest or unsportsmanlike conduct.  
   • Reliability — fulfill commitments; do what I say I will do; be on time to practices, games, and events.
   • Loyalty — be loyal to my organization and team; put the team above personal glory.

RESPECT

2. Respect — treat all people with respect all the time and require the same of other participants. Show respect to yourself. Show respect to the space.

3. Class — be a good sport; be gracious in success and accept defeat with dignity; give fallen opponents help, compliment extraordinary performance, show sincere respect in all aspects of my participation.

4. Disrespectful Conduct — don’t engage in disrespectful conduct of any sort including profanity, obscene gestures, offensive remarks of a sexual or racial nature, trash-talking, taunting, boastful celebrations, or other actions that demean individuals or the activity.

5. Respect Officials — treat contest officials with respect; don’t complain about or argue with official calls or decisions during or after an athletic event.

RESPONSIBILITY

6. Importance of Good judgment — practice reasonable and logical manners in all situations representing the organization.

7. Role-Modeling — remember, participation is a privilege, not a right.  I am expected to represent my organization, coach or director, and fellow participants with honor, on and off the field. Consistently exhibit good character and conduct yourself as a positive role model. Suspension or termination of the participation privilege is within the sole discretion of the organization.

8. Self-Control — exercise self-control; don’t fight or show excessive displays of anger or frustration; have the strength to overcome the temptation to retaliate.

9. Healthy Lifestyle — safeguard your health; avoid any illegal or unhealthy substances including alcohol, tobacco, and drugs, or engage in any unhealthy techniques to gain, lose, or maintain weight.

10. Integrity of the Game — protect the integrity of the game. Play the game according to the rules.

FAIRNESS

11. Be Fair — live up to high standards of fair play; be open-minded; always be willing to listen and learn.

CARING

12. Concern for Others — demonstrate concern for others; never intentionally injure any participant or engage in reckless behavior that might cause injury to myself or others.

13. Teammates — help promote the well being of teammates through positive praise and encouragement, or by reporting any unhealthy or dangerous conduct to coaches or directors.

CITIZENSHIP

14.Play by the Rules — maintain a thorough knowledge of and abide by all applicable game and competition rules.

15.Spirit of rules — honor the spirit and the letter of rules; avoid temptations to gain competitive advantage through improper gamesmanship techniques that violate the highest traditions of sportsmanship.

I have read and understand the requirements of this Code of Conduct. I understand that I’m expected to perform according to this code and I understand that there may be sanctions or penalties if I do not.    

Date: __{sign_date}____

This code of conduct is provided by Francis L. Dean & Associates, Inc., a national provider of sports, leisure and entertainment insurance.  For more information, please visit www.fdean.com.