City of Ripon Parks & Recreation Department
Registration Form
259 N. Wilma Avenue, Ripon, CA 95366 Phone (209) 599-2108 Now register online at: www.cityofripon.org
2017 Co-ed Tee Ball League– Ages 4, 5, and 6 The Ripon Parks & Recreation Department will once again offer a Tee Ball League for four, five and six year old boys and girls, who are too young to play in our baseball or softball leagues. The 4/5 year old league will use the tee exclusively and the 6 year old league will be coach pitch (3 pitches only-then placed on tee). Anyone signing up after the deadline will be placed on a waiting list. All games will be played at Stouffer or Mistlin Fields Monday – Thursday. Opening day is scheduled for the first or second week of May 2017. Please register online by February 9, 2017 at www.cityofripon.org and drop off payment at City Hall. Make checks payable to “Ripon Parks & Recreation. The fee is $85.00 per player and no refunds will be issued after your child has been placed on a team. Please call (209) 599-2108 with any questions about the softball program.
_________________________________Cut here and return to City Hall______________________________________
2017 CO-ED TEE BALL REGISTRATION FORM Participant’s First and Last name
M/F
Birth date/ Age (by 5-31-17)
Grade
School
Fee $85.00 $
Deadline Date: February 9, 2017 Late registration fee of $10.00 (applies if registration is received after the specified deadline for the activity) Shirt Size (please circle) YM YL AS AM AL AXL Total fees $ Office Use Only:
Date:
Payment Type: Cash [ ] or Check [ ]
$
*Please make checks payable to: Ripon Parks and Recreation. You may register by mail, in person at City Hall, or online before the deadline date. Acknowledgement of Risk and Waiver of Liability I understand that my child’s participation in the activity set forth in this Registration Form may lead to injuries, accidents, damages and/or death. With full knowledge of the risks associated with my child’s participation in the activity, I voluntarily request permission for my child to participate in the activity. I understand and agree that as a condition of the City of Ripon permitting my child to participate in the activity set forth in this Registration Form, I must acknowledge the risks associated with the activity and waive any right to pursue any legal or equitable action against the City of Ripon that may arise from my child’s participation in the activity. I hereby agree to assume all risks and hazards related to the activity and hereby agree to waive any and all claims against the City of Ripon which may arise out of or relate to my child’s participation in the activity, including, but not limited to, all claims for personal injury, death or property damage, regardless of the cause. This waiver of liability extends to the City of Ripon, its employees, officers, City Council members, instructors, volunteers, officials, sponsors, and any other person or entity acting in conjunction with or on behalf of the City of Ripon. I further understand and agree that this acknowledgment of risk and waiver of liability is binding on my child and other family members, heirs, successors and assigns.
Household / Primary Adult Contact First & Last name (Print) Relationship to participant (s) Street Address City, State, Zip Home Phone Work Phone Cell Phone Email
________________________________________ Parent or Guardian Signature required
Date
The following needs to be completed by a Parent/Guardian : I, _________________________________________ I, _________________________________________ I, _________________________________________
am willing to coach a team. am willing to assist in coaching a team. am willing to sponsor a team for $200.00 – provide separate check