2017 Spring Registration
Frederick County American Little League Player Registration Form Spring 2017 Player’s Name: Address: City/State/ZIP: Birth Date: Home Phone: School:
Place a check before all that apply Gender: Male Female
Parent’s Name: Address (if different): City/State/ZIP: Home Phone: Cell Phone: Email: Occupation: I would like to volunteer as a: ( ) Manager ( ) Coach ( ) Umpire (
Baseball ( ) T-Ball (4-6 years) ( Coach Pitch (6-8 years) ( ) Minor (8-10 years) ( ) Major (10-12 years) ( ) 50/70 (12-13 years) ( ) Junior (12-14 years) ( ) Senior (14-16 years) Softball ( ) T-Ball (4-6 years) ( ) Coach Pitch (6-8 years) ( ) Minor (8-10 years) ( ) Major (10-12 years) ( ) Junior/Senior (13-16 years)
( ) Re-enter me into the draft. ) Auxiliary
Parent’s Name: Address (if different): City/State/ZIP: Home Phone: Cell Phone:
Player’s Medical Information Emergency Contact Relationship
League Use Only League Age: Birth Certificate: Y N Medical Release: Y N Proof of Residency: 1: 2: 3: Waiver Type: Division Assigned: Team Assigned: Try Out Needed: Try Out Date: Fee Amount: Check #:
Insurance Carrier Policy Number Phone Number
Email: Uniform Sizes YXS, YS, YM, YL, YXL, Occupation: Shirt Size AS, AM, AL, AXL, AXXL I would like to volunteer as a: Manager Coach Umpire Auxiliary 2017 Registration Fees: $80-1st child; $70-2nd child; $60-3rd child; Free-4th child (and beyond) DISCOUNTS: Register on October 29, 2016 for a $10 discount per child. LATE FEES: A $20 late fee per child registered after Jan. 31, 2017. Please make check payable to: FCALL Mail check, registration form, copies of three proofs of residency, and a copy of the child’s Birth Certificate to:
PO Box 2412, Winchester, VA 22604 Visit www.eteamz.com/fcall for any forms needed.
1. I/We, the parents/guardians of the above-named candidate for a position on a Little League team, hereby give my/our approval to participate in any and all Little League activities, including transportation to and from the activities. 2. I/We know that participation in baseball or softball may result in serious injuries and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnify, and agree to hold harmless the local Little League, Little League Baseball, Incorporated, the organizers, sponsors, supervisors, participants, and persons transporting my/our child to and from activities from any claim arising out of any injury to my/our child whether the result of negligence or for any other cause. 3. I/We agree to return upon request the uniform and other equipment issued to my/our child in as good conditions as when received except for normal wear and tear. 4. I/We agree that our child (candidate) may be required to try out for a team. If such does not attend at least 50 percent of the tryouts, local Board-of -Directors' approval is required for such candidate to be placed on a team. 5. I/We understand that our child (candidate) may be chosen at anytime to play on a Major Division team, if he or she is of the correct age for such division as determined by the local league and Little League Baseball. Declining to move up to such Major Division team will result in forfeiture of eligibility for the Major Division for the current season, and may be subject to further restrictions by the local league. 6. I/We agree to provide proof of legal residence (as defined by Little League Baseball, Incorporated) and age. I/We understand that our child (candidate) must be eligible under the residence and age regulations of Little League Baseball, Incorporated, to participate in this Local League, and that if any controversy arises regarding residence and/or age, the decision of the Charter Committee in Williamsport shall be final and binding. I/We further understand that if any participant on a Little League team does not qualify for participation in the league based on residence (as defined by Little League Baseball, Incorporated) and/or age, such participant and/or team on which he/she participates be found ineligible, and forfeit(s) and/or suspension of Tournament privileges may be decreed by action of the Charter Committee or Tournament Committee. 7. I/We will furnish a certified birth certificate of the above-named candidate to League Officials.® 8. I/We agree to the Refund Policy, as written, which can be found at www.eteamz.com/fcall/handouts. 9. I/We agree that the uniform size selected during registration is final. If the uniform size selected does not fit, the parent/guardian will be financiall responsible for the replacement uniform. FCALL will not pay for the replacement.
Signature
Date
How did you hear about registration: ( )TV
( )School Flyer Other:
( )Website
( )Radio ( )Facebook ( )Mailer
Please mark where you live on the FCALL Boundary Map below: (If you do not live within the FCALL boundaries, you must go to school within the boundaries. A School Waiver will be required).
Media Release I, the parent/guardian of this registrant(s) hereby give my permission to Frederick County American Little League, hereafter known as FCALL, to use photographs of the above listed minor in any publication, media release, promotional announcement or advertisement, electronic or otherwise. I agree that neither the above listed minor, nor l, will receive any compensation if such image appears in such publication, media release, promotional announcement or advertisement, electronic or otherwise. I understand that such image is the property of FCALL. In addition, I understand that FCALL may supply such images to, or for the use and publication by, a corporate sponsor or licensee of FCALL in or for any commercial venture or advertisement, without my permission, if the use or publication is directly related to or in support of FCALL.
Signature: _______________________________________
Date: ________________________
Place a check before all that apply Gender: Male Female
Parent’s Name: Address (if different): City/State/ZIP: Home Phone: Cell Phone: Email: Occupation: I would like to volunteer as a: ( ) Manager ( ) Coach ( ) Umpire (
Baseball ( ) T-Ball (4-6 years) ( Coach Pitch (6-8 years) ( ) Minor (8-10 years) ( ) Major (10-12 years) ( ) 50/70 (12-13 years) ( ) Junior (12-14 years) ( ) Senior (14-16 years) Softball ( ) T-Ball (4-6 years) ( ) Coach Pitch (6-8 years) ( ) Minor (8-10 years) ( ) Major (10-12 years) ( ) Junior/Senior (13-16 years)
( ) Re-enter me into the draft. ) Auxiliary
Parent’s Name: Address (if different): City/State/ZIP: Home Phone: Cell Phone:
Player’s Medical Information Emergency Contact Relationship
League Use Only League Age: Birth Certificate: Y N Medical Release: Y N Proof of Residency: 1: 2: 3: Waiver Type: Division Assigned: Team Assigned: Try Out Needed: Try Out Date: Fee Amount: Check #:
Insurance Carrier Policy Number Phone Number
Email: Uniform Sizes YXS, YS, YM, YL, YXL, Occupation: Shirt Size AS, AM, AL, AXL, AXXL I would like to volunteer as a: Manager Coach Umpire Auxiliary 2017 Registration Fees: $80-1st child; $70-2nd child; $60-3rd child; Free-4th child (and beyond) DISCOUNTS: Register on October 29, 2016 for a $10 discount per child. LATE FEES: A $20 late fee per child registered after Jan. 31, 2017. Please make check payable to: FCALL Mail check, registration form, copies of three proofs of residency, and a copy of the child’s Birth Certificate to:
PO Box 2412, Winchester, VA 22604 Visit www.eteamz.com/fcall for any forms needed.
1. I/We, the parents/guardians of the above-named candidate for a position on a Little League team, hereby give my/our approval to participate in any and all Little League activities, including transportation to and from the activities. 2. I/We know that participation in baseball or softball may result in serious injuries and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnify, and agree to hold harmless the local Little League, Little League Baseball, Incorporated, the organizers, sponsors, supervisors, participants, and persons transporting my/our child to and from activities from any claim arising out of any injury to my/our child whether the result of negligence or for any other cause. 3. I/We agree to return upon request the uniform and other equipment issued to my/our child in as good conditions as when received except for normal wear and tear. 4. I/We agree that our child (candidate) may be required to try out for a team. If such does not attend at least 50 percent of the tryouts, local Board-of -Directors' approval is required for such candidate to be placed on a team. 5. I/We understand that our child (candidate) may be chosen at anytime to play on a Major Division team, if he or she is of the correct age for such division as determined by the local league and Little League Baseball. Declining to move up to such Major Division team will result in forfeiture of eligibility for the Major Division for the current season, and may be subject to further restrictions by the local league. 6. I/We agree to provide proof of legal residence (as defined by Little League Baseball, Incorporated) and age. I/We understand that our child (candidate) must be eligible under the residence and age regulations of Little League Baseball, Incorporated, to participate in this Local League, and that if any controversy arises regarding residence and/or age, the decision of the Charter Committee in Williamsport shall be final and binding. I/We further understand that if any participant on a Little League team does not qualify for participation in the league based on residence (as defined by Little League Baseball, Incorporated) and/or age, such participant and/or team on which he/she participates be found ineligible, and forfeit(s) and/or suspension of Tournament privileges may be decreed by action of the Charter Committee or Tournament Committee. 7. I/We will furnish a certified birth certificate of the above-named candidate to League Officials.® 8. I/We agree to the Refund Policy, as written, which can be found at www.eteamz.com/fcall/handouts. 9. I/We agree that the uniform size selected during registration is final. If the uniform size selected does not fit, the parent/guardian will be financiall responsible for the replacement uniform. FCALL will not pay for the replacement.
Signature
Date
How did you hear about registration: ( )TV
( )School Flyer Other:
( )Website
( )Radio ( )Facebook ( )Mailer
Please mark where you live on the FCALL Boundary Map below: (If you do not live within the FCALL boundaries, you must go to school within the boundaries. A School Waiver will be required).
Media Release I, the parent/guardian of this registrant(s) hereby give my permission to Frederick County American Little League, hereafter known as FCALL, to use photographs of the above listed minor in any publication, media release, promotional announcement or advertisement, electronic or otherwise. I agree that neither the above listed minor, nor l, will receive any compensation if such image appears in such publication, media release, promotional announcement or advertisement, electronic or otherwise. I understand that such image is the property of FCALL. In addition, I understand that FCALL may supply such images to, or for the use and publication by, a corporate sponsor or licensee of FCALL in or for any commercial venture or advertisement, without my permission, if the use or publication is directly related to or in support of FCALL.
Signature: _______________________________________
Date: ________________________
