Baseball Registration Form - City Of Spartanburg, South Carolina printable pdf download

Baseball Registration

Any child living in the City limits of Spartanburg and attending a Dist. 7 School : $15.00 Registration Fee

Any child living outside the City limits and/or not attending a Dist. 7 School: $20.00 Registration Fee

Name: (First) _____________________________________ (Last) ______________________________________

Age:_________ Date of Birth:________________ School / Grade:_______________________________________

Copy of Birth Certiﬁcate (Required): Yes

Medical Conditions: ___________________________________________________________________________

Special Needs:________________________________________________________________________________

(In an eﬀort to better serve you please acknowledge if your child has any special needs)

For Parent or Guardian

Name: _________________________________________(Last)___________________________________________________________

Address: ___________________________________________________ City: ___________________ State: ________ Zip: ___________

Phone: (h) _________________________________ (w) _________________________________ (c) ______________________________

Email address of parent or guardian (if available) ______________________________________________________________________

Emergency contact other than parent or guardian_____________________________________________________________________

Phone: (h) ____________________________________(w)_______________________________(c)______________________________

Relationship to participant:________________________________________________________________________________________

Yes

WOULD YOU LIKE TO BE A VOLUNTEER COACH:

AUTHORIZATIONS and RELEASE:

Photograph Permission: I give permission for the City of Spartanburg to use any pictures of my child for future promotional purposes.

Medical Treatment: I herby give permission for my child to be given cardiopulmonary resuscitation (CPR) and ﬁrst aid treatment by

a qualiﬁed staﬀ member in the event I cannot be contacted, I also give permission for my child to be transported by ambulance to an

emergency center for treatment. I further consent to the disclosure of health information and to the medical, surgical, and hospital

care treatment and procedures (including, but not limited to, administration of necessary anesthetics, tests, x-ray examinations,

transfusions, injections, and drugs) to be performed for my child by a licensed physician or hospital selected by the City of

Spartanburg when deemed immediately necessary or advisable by the physician to safeguard my child’s health.

Release from Liability: Recognizing the City of Spartanburg will do its best to ensure a safe experience, I understand that accidents

may occur both from my child’s participation in youth sports activities and from transportation to and from the program. I agree to

assume these risks. By signing below, I release the City of Spartanburg and its agents from all liability based on any damage, loss or

injury whether it is the result of ordinary negligence or otherwise, caused to my child or to me, from participation in the youth sports

program.

I have read and understand the above and have completed this form to the best of my ability.

Signature of parent or legal guardian:______________________________________________Date:_________________________

For more information please contact James Rice 5 62- 43 8 7 or

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Baseball Registration Form - City Of Spartanburg, South Carolina