Sport:
Student-Athlete’s Name: Stud. #_____________
Local Phone Number: _____________________
Reason for deletion: (check one) Quit Team
Cut/Dismissed from team**
Date of roster change: / /
Did this student-athlete receive coaching? Yes No
Did this student-athlete play against outside competition? Yes No
Is student-athlete on athletic scholarship? Yes No
If yes, are you requesting cancellation of an athletics scholarship? Yes# No
Coach’s Signature: Date:
# Must complete the Scholarship Status Change Form.
**Please provide rationale and attach any supporting documentation regarding the roster deletion. NOTE: The Sport Administrator and Director of Athletics signature will be required for roster deletions to become official. Approval of deletions should be requested before announcement to the student-athlete.
______________________________________________ ________________
Sport Administrator Signature Date
Comments:
_____________________________________________ _________________
Director of Athletics Signature Date
Approved Denied
Return completed form to William Morris,Compliance Office ULGC
NIAGARA UNIVERSITY ATHLETIC DEPARTMENT
VOLUNTARY WITHDRAWAL STATEMENT
I, __________________________, voluntarily withdraw from the ______________team for personal reasons. As is stated in my Niagara University Athletics Award Agreement, by voluntarily withdrawing, I understand I am no longer eligible for intercollegiate athletics at Niagara University in the sport of _____________________. I also understand my athletic grant may be terminated during the period of its award. I release Niagara University from any further obligation to continue any athletic grant now available to me.
____________________________ _____________________
(Student-athlete’s signature) (Date)
NIAGARA UNIVERSITY
DEPARTMENT OF ATHLETICS
WALK-ON CLEARANCE FORM
Directions: It is the student-athlete’s responsibility to complete this worksheet with all of the required signatures. All signatures must be obtained in the order listed. Steps #1-#5 must be completed prior to any practice activities. All questions regarding this form should be directed to the Associate Athletic Director for Compliance.
Step #1: General Information (Completed by the student-athlete)
Name: ___________________ Social Security #: ___________________
Sport: __________________________ Phone #: _________________________
Step #2: Head Coach Information
I confirm that I have spoken with this student-athlete and am willing to provide for him/her to have an opportunity to be a part of my program, if eligible. I also confirm that this student-athlete was not recruited by Niagara University.
______________________ ___________________________
Date Signature of Head Coach
Step #3: Training Room Staff
I confirm that this student-athlete has a current physical examination form and proof of insurance card on file in the training room.
______________________ ____________________________
Date Signature of Athletic Trainer
Step #4: Associate Athletic Director for Compliance
I confirm that this student-athlete is enrolled as a full-time student (minimum of 12 credit hours) at Niagara in the current semester. I also confirm that this student-athlete has completed the following: (1) NCAA Student-Athlete Statement, (2) NCAA Drug Testing Consent Form, and (3) Student-Athlete Information Form.
________________________________________________ __________________
Signature of Associate Director of Athletics for Compliance Date
NIAGARA UNIVERSITY PARTICIPATION LIST
Please send in your Participation List for each sport immediately after the completion of the respective season. Every student-athlete that competed in any contest during the year must be listed. Also, this list should include student-athletes who have been redshirted or who have competed but have or will receive a “Hardship Waiver”. Please return this form to the Athletic Compliance Office.
SPORT: YEAR:
1. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs.Rem
2. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
3. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
4. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
5. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
6. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
7. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
8. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
9. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
10. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
11. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
12. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
13. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
14. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
15. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
16. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
17. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
18. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
19. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
20. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
21. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
22. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
23. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
24. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
25. □ Competed □ Practiced Only □ Hardship □ Redshirted Yrs. Rem
Head Coach (signature): Date:
Associate AD - Compliance (signature): Date:
Niagara University Department of Athletics
Declaration of Coaching Staff & Permissible Recruiters
Sport:___________________________ Academic Year:_____________
Listed below are the staff members for my sport, their designated coaching category, and off-campus recruiter status:
Name Category Permissible Recruiter (Y/N)
1.________________________________________________________________________
2.________________________________________________________________________
3.________________________________________________________________________
4.________________________________________________________________________
5.________________________________________________________________________
Recruiting/Compliance Paperwork Liaison:________________________________
I understand that an individual who coaches and either is compensated or receives compensation or remuneration of any sort from the institution, even if such compensation or remuneration is not designated for coaching, shall be designated as a head coach, assistant coach, restricted coach, volunteer coach, graduate assistant coach, or an undergraduate assistant coach.
An Department of Athletics staff member must count against coaching limits as soon as the individual participated (in any manner) in the coaching of the intercollegiate team in practice, games, or organized activities directly related to that sport, including and organized staff activity directly related to that sport.
I hereby certify that I have read the statement above and the information is correct. In addition, I will immediately notify the Athletics Compliance Staff if any changes to the coaching staff are made.
_____________________________________ ________________
Signature of Head Coach Date
_____________________________________ ________________
Signature of Associate AD - Compliance Date
NU SPORTS PRE- AND POST CAMP/CLINIC CHECKLIST
Camp/Clinic: Camp Dates: From: To:
Name of Camp Director:
PRE-CAMP/CLINIC REQUIREMENTS:
OWNERSHIP OR OPERATION OF CAMP/CLINIC
Yes No 51 percent owned by an athletic department employee
Yes No Athletic department employee is personally and directly responsible for managing and operating the camp/clinic.
Yes No Is this a developmental camp/clinic?
EMPLOYEES
Camp/clinic staff roster (see form: NU Sports Camp/Clinic Staff and Compensation Form)
Written description of responsibilities for all employees (see form: NU Job Description for Employees)
Written description of any benefits given to employees (i.e., transportation)
ADS OR BROCHURES
Copies of all advertisements, brochures or website links & materials [in advance of print or distribution]
REGISTRATION
Copy of application
Written participation policies specifically outlining the following:
Restrictions on participants (i.e., age, sex, number)
The camp/clinic is open to any and all entrants
Camp/clinic participation is first-come, first-served
FEES
Procedures for depositing and expending funds pertaining to registration fees (include location of funds)
Written fee policies outlining the following:
When discounts will be allowed
Copies of all NU Free or Reduced Admission Recipient/Group Requests
Description of refund policy
CAMP/CLINIC ACTIVITIES
Description of camp activities or schedule of events
OUTSIDE SPONSORSHIP
Documentation of any corporate sponsorship
Documentation of sponsorship of any transportation
AWARDS OR MERCHANDISE
Written description of any awards that will be distributed to participants
Written description of any free merchandise that will be provided to participants
Written description of concession arrangements (i.e., types of merchandise, concession employees, etc.)
POST-CAMP/CLINIC REQUIREMENTS:
NU Camp/Clinic Final Registration List
Copies of each camp/clinic application, including the following:
School
Grade
Age
Athletics Award Winner
Copies of Cash Receipts/Money Orders/Checks
NU Camp/Clinic Refund List
NU Camp/Clinic Financial Report/Accounting Form
FINAL NU Sports Camp/Clinic Staff and Compensation Form
NU SPORT CAMP/CLINIC STAFF & COMPENSATION FORM
Camp/Clinic: Date:
Total # of Staff: Total Salary Amount:
Student-athletes *:
Camp/Clinic Compensation/
Name Affiliation Staff Position Amount **
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
High-School / Two-Year College Coaches:
Camp/Clinic Compensation/
Name Affiliation Staff Position Amount **
1.
2.
3.
4.
5.
Other:
Camp/Clinic Compensation/
Name Affiliation Staff Position Amount **
1.
2.
3.
4.
5.
Note: Department of Athletics staff members will be documented on NU Camp/Clinic Financial Report/Accounting Form.
TOTAL SALARY FOR ALL EMPLOYEES SHOULD BE RECORDED ON NU CAMP/CLINIC FINANCIAL REPORT/ACCOUNTING FORM, PAGE 2, LINES A-E.
COMPLETE SEPARATE LOG FOR EACH SESSION OF CAMP/CLINIC. USE ADDITIONAL SHEETS IF NECESSARY.
*All student-athlete employees must receive written approval from athletic compliance office prior to beginning of any camp.
** If transportation expenses or mileage will be provided or reimbursed for any camp employee, please include a notation and the value associated with this benefit in the Compensation/Amount column.
NU JOB DESCRIPTION FOR NU CAMP/CLINIC
EMPLOYEES
POSITION TITLE: SPORT:
EMPLOYEE NAMES UNDER THIS TITLE:
1. Institutional Staff Member Student-Athlete H.S. Coach
Employee Name Other:
2. Institutional Staff Member Student-Athlete H.S. Coach
Employee Name Other:
3. Institutional Staff Member Student-Athlete H.S. Coach
Employee Name Other:
4. Institutional Staff Member Student-Athlete H.S. Coach
Employee Name Other:
5. Institutional Staff Member Student-Athlete H.S. Coach
Employee Name Other:
Mark all responsibilities of this employee and indicate approximate % of time allocated to each duty:
% Register participants
% Supervise participants between sessions
% Supervise recreational activities
% Supervise grounds
% Keep time/score
% Set-up or maintain facilities or equipment
% Tear down facilities or equipment
% Conduct educational sessions
% Officiate/Referee
% Lecture/Demonstrate
% Coach (instruct drills, develop skills, coach games)
% Other (describe):
Submitted by Camp Director Date
Approved by Associate AD for Compliance Date
NU SPORTS CAMPS/CLINICS FINAL REGISTRATION LIST
Camp/Clinic: Date(s):
Camper Count: # Residents # Commuters # Free/Reduced
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Amount and Method of Payment
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Name of Camper
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Grade
Age
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Credit
Card
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Cash*
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Check*
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Discount / Free**
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Total Paid
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Resident /
Commuter
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Were any checks returned due to insufficient funds (please specify)? Yes No
Name of Attendee(s):
If yes, what means were used to collect the money?
TOTAL AMOUNT PAID FOR ALL CAMPERS SHOULD BE RECORDED ON NU CAMP/CLINIC FINANCIAL REPORT/ACCOUNTING FORM, PAGE 1, LINES A-E.
COMPLETE SEPARATE LOG FOR EACH SESSION OF CAMP/CLINIC. USE ADDITIONAL SHEETS IF NECESSARY. COMPUTERIZED VERSIONS WITH SAME INFORMATION MAY BE USED.
* Copies of all cash receipts or checks should be maintained with the payment ledger/registration list.
NU CAMP/CLINIC FINANCIAL REPORT /ACCOUNTING REPORT
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