Registration Brochure - Gardendale First Baptist Church

PARTICIPANT REGISTRATION FORM
BASEBALL q
Last Name
SOFTBALL q
First Name
MI Gender
Address
Bring or mail your registration form and fee to:
Gardendale First Baptist Church
940 Main Street • Gardendale, AL 35071
Parents can drop off their form and registration fee at the
Family Life Center between 8:00 a.m. and 5:00 p.m. Monday
through Friday.
REGISTRATION INFORMATION
Early registration is $90 per child.
City
Home Phone
DOB
State Zip Code
FATHER/GUARDIAN INFORMATION
Age
Church
MOTHER/GUARDIAN INFORMATION
Last Name
First Name
Relationship
Last Name
First Name
Relationship
Home Phone
Work Phone
Cell Phone
Home Phone
Work Phone
Cell Phone
E-Mail
E-Mail
COACHES
After February 9, the cost is $105.
Deadline to register is February 16.
Space is limited. No refunds after February 16.
BASEBALL/SOFTBALL EVALUATIONS:
Every player MUST attend. T-Ball evaluations take place at GFBC FLC. All other evaluations take place at Upward Park on the GFBC Athletic Fields.
BASEBALL
6 & Under T-Ball/Coach Pitch
NUMBER OF YEARS PLAYED _____
SOFTBALL
Monday, February 22
6:30 - 7:30 p.m.
6 & Under T-Ball/Coach Pitch
Monday, February 22
6:30 - 7:30 p.m.
9 & Under Coach Pitch
Saturday, February 20
1:30 - 3:30 p.m.
9 & Under Coach Pitch
Saturday, February 20
1:30 - 3:00 p.m.
12 & Under
Saturday, February 20
11:00 a.m. - 12:30 p.m.
12 & Under
Saturday, February 20
11:00 a.m. - 12:30 p.m.
LEAGUE SCHEDULE:
Practice begins the week of March 7. Opening Day is April 9. There will be some night games.
For more information call Mike Cornelius:
GFBC Family Life Center • 205.488.8670
Would you like to coach? Yes q No q
Would you like to umpire? Yes q No q
OFFICE USE ONLY
*Jersey/Shirt Size
YS
(check one)
YM
YL
YXL
AM
AL
AXL
*Short Size
(Softball Only)
YS
YM
YL
AS
AM
AL
AXL
PLEASE READ CAREFULLY - RELEASE MUST BE SIGNED
Does this child have any disabilities, handicaps, present injuries or limitations, allergies, heart condition, history of
Please check which league you would like to register for:
respiratory illness or any other significant medical condition? YES NO
If yes, please state conditions: _______________________________________________________ DIVISION
TYPE
BIRTHDATES
If you wish to have your family doctor contacted in case of an emergency, please provide contact information.
q 6 & Under
Coach Pitch/T-Ball
Must turn 5 by 4/1/16
Doctor’s Name _______________________________________ Phone ______________________
Baseball
Cannot turn 7 before 6/1/16
Coach Pitch/T-Ball
Must turn 5 by 4/1/16
Cannot turn 7 before 6/1/16
q 9 & Under
WAIVER OF LIABILITY AND DISCLAIMER: I, the parent or guardian of the above named individual, acknowledge
that participation in athletic events necessarily involves the risk of physical injury. I further acknowledge that the
Baseball
programs in Upward Baseball/Softball League are primarily administered by parents who volunteer their time, rather
than paid professionals. In consideration for accepting the registration of the above named individual and permitting q 9 & Under
the voluntary participation of said individual in its programs, I hereby release, discharge and hold harmless the Upward Softball
Baseball/Softball League, its employees, volunteers and other representatives from any claims arising out of or relating to any physical injury that may result to said individual while participating in the Upward Baseball/Softball League q 12 & Under
sponsored events, including any physical injury due to negligence of any official, umpire or coach while performing his/
Baseball
her duties during any practice or games.
Coach Pitch
Cannot turn 10 before 6/1/16
Coach Pitch
Cannot turn 10
before 6/1/16
Kid Pitch
Cannot turn 13
before 6/1/16
Signature of Parent or Guardian _______________________________________ q 12 & Under
Machine Pitch
Cannot turn 13
before 6/1/16
EMERGENCY AUTHORIZATION (from above): I the undersigned parent or legal guardian of the participant,
a minor, hereby authorize the coaches, assistant coaches or parents of team members acting in the capacity
q 6 & Under
of activity supervisors/vehicle drivers, as my Agents to consent to medical, surgical or dental examination
Softball
and/or treatment. In case of emergency, I hereby authorize treatment, and/or care at any hospital.
AUTHORIZATION SIGNATURE _______________________________________________________ Softball
Date _____________________
+
Participant Fee
=
Late Fee
Total Paid