2017 Summer Blastball/T-ball
2017 Summer Blastball/T-ball KINGMAN REGISTRATION FORM Please fill in EVERY blank on this Registration form.
Mission Statement:
Deadline: 4/13/17: $25.00 Last Day of Entries: 4/21/17: $35.00 *Last Day of Entries is the last day that your signup will guarantee a spot on a team.
To enhance the mental and physical health, happiness, well being, and quality of life of all those residing in and around USD 331 through quality social, educational, and recreational activities.
(Checkmark box next to appropriate League) Blastball (4 yrs old by June 1, 2017 but NOT entering Kindergarten for 2017-2018 School Year) Co-ed T-ball (Either Currently Kindergarten 2016-2017 or entering Kindergarten for 2017-2018 School Year)
Name: _______________________________________ Sex (circle one): M F Grade level (2016-17):_____ Grade level (2017-18)_____ Age: (as of 6/1/17)_____ Date of birth: _____________ Circle shirt size: YS YM YL AS AM Deadline: 4/13/17 Fee before Deadline: $25.00 Last Day of Entries: 4/21/17 (Last day to guarantee your child a spot on a team) Fee: 4/14/17 to 4/21/17: $35.00 Drop Box Locations: -Eagles Landing, 131 West A Ave., Kingman
Parents:(circle one) Coach: Yes No KNRC COACH SELECTION PROCESS: Everyone interested in being a head coach will be put into a blind drawing. Depending on the number of teams, the first ones drawn out will be head coaches. The second ones will be assistants. Coaches are only allowed to choose their assistant coach if one of them does not have a child in the program.
*GAMES ARE PLAYED THE MONTH OF JUNE!!
-East Entrance, Norwich Office, 241 E. 2nd, Norwich
NOTICE: Teams in these divisions are selected by KNRC staff. Coaches that are drawn will be notified about a rules meeting in which they will receive their roster and rules. The coaches will then contact the players. Waiver Statement The undersigned states that he/she understands that the Kingman-Norwich Recreation Commission (KNRC) is not and shall not be responsible for or liable for any illness, injury to person, or damage to property resulting from the program in which the undersigned is enrolling or from his/her participating in said program, and the undersigned hereby forever releases and holds harmless KNRC from any and all claims of any kind that the undersigned or his/her heirs, executors, administrators, or assigns may have or claim to have resulting in any way from his/her participation in said program. I have read and understand the waiver statement and give permission for participant named above to participate in the KNRC program stated above.
Please print name of Legal Guardian(s): _________________________________________________ Signature of Legal Guardian(s): ___________________________________ Date ______________ Address: ____________________________________________________________________________ Home Phone#: _______________ Work Phone #: _______________ Cell Phone#: _________________ Email address:_________________________________________________________________________ Participant’s pertinent medical information: ________________________________________________ *Kingman-Norwich Recreation Commission reserves the right to take photos/videos of all programs and participants and use them for advertisement/promotion. If you have any concerns please contact the Director Personally. E-mail: [email protected] KNRC Website: knrec.org Join us on FACEBOOK
Mission Statement:
Deadline: 4/13/17: $25.00 Last Day of Entries: 4/21/17: $35.00 *Last Day of Entries is the last day that your signup will guarantee a spot on a team.
To enhance the mental and physical health, happiness, well being, and quality of life of all those residing in and around USD 331 through quality social, educational, and recreational activities.
(Checkmark box next to appropriate League) Blastball (4 yrs old by June 1, 2017 but NOT entering Kindergarten for 2017-2018 School Year) Co-ed T-ball (Either Currently Kindergarten 2016-2017 or entering Kindergarten for 2017-2018 School Year)
Name: _______________________________________ Sex (circle one): M F Grade level (2016-17):_____ Grade level (2017-18)_____ Age: (as of 6/1/17)_____ Date of birth: _____________ Circle shirt size: YS YM YL AS AM Deadline: 4/13/17 Fee before Deadline: $25.00 Last Day of Entries: 4/21/17 (Last day to guarantee your child a spot on a team) Fee: 4/14/17 to 4/21/17: $35.00 Drop Box Locations: -Eagles Landing, 131 West A Ave., Kingman
Parents:(circle one) Coach: Yes No KNRC COACH SELECTION PROCESS: Everyone interested in being a head coach will be put into a blind drawing. Depending on the number of teams, the first ones drawn out will be head coaches. The second ones will be assistants. Coaches are only allowed to choose their assistant coach if one of them does not have a child in the program.
*GAMES ARE PLAYED THE MONTH OF JUNE!!
-East Entrance, Norwich Office, 241 E. 2nd, Norwich
NOTICE: Teams in these divisions are selected by KNRC staff. Coaches that are drawn will be notified about a rules meeting in which they will receive their roster and rules. The coaches will then contact the players. Waiver Statement The undersigned states that he/she understands that the Kingman-Norwich Recreation Commission (KNRC) is not and shall not be responsible for or liable for any illness, injury to person, or damage to property resulting from the program in which the undersigned is enrolling or from his/her participating in said program, and the undersigned hereby forever releases and holds harmless KNRC from any and all claims of any kind that the undersigned or his/her heirs, executors, administrators, or assigns may have or claim to have resulting in any way from his/her participation in said program. I have read and understand the waiver statement and give permission for participant named above to participate in the KNRC program stated above.
Please print name of Legal Guardian(s): _________________________________________________ Signature of Legal Guardian(s): ___________________________________ Date ______________ Address: ____________________________________________________________________________ Home Phone#: _______________ Work Phone #: _______________ Cell Phone#: _________________ Email address:_________________________________________________________________________ Participant’s pertinent medical information: ________________________________________________ *Kingman-Norwich Recreation Commission reserves the right to take photos/videos of all programs and participants and use them for advertisement/promotion. If you have any concerns please contact the Director Personally. E-mail: [email protected] KNRC Website: knrec.org Join us on FACEBOOK
