2014 REGISTRATION FORM Player Name:________________________________________________Birth Date:_______________

Transcription

2014 REGISTRATION FORM Player Name:________________________________________________Birth Date:_______________
2014 REGISTRATION FORM
Player Name:________________________________________________Birth Date:_______________
(please print)
Male:Age as of 4/30/14:_________ Female:Age as of 01/01/14:_________ Current Grade:______
PRIMARY CONTACT INFORMATION (please print)
Name:__________________________________________________________________________
Address:________________________________________________________________________
Email:__________________________________________________________________________
Home Phone:________________________________Cell Phone:__________________________
MOST COMMUNICATIONS WILL BE DONE VIA PRIMARY EMAIL ADDRESS!
Check Below
Division
Days
Fee
____________
____________
T-Ball (5-6 year olds)
T-Ball (5-6 year olds)
M/W
*T/Th
$30.00
$30.00
*Depends on interest and number of registrations. 1st choice will try to be honored but not guaranteed.
Games played on Brice Prairie (BP). Player receives shirt and hat.
____________
Rookie (7-8 year olds)
T/Th
$30.00
Teams will play on BP and Holmen fields; Tournament game on last Saturday in July.
Player receives shirt and hat.
____________
____________
____________
____________
____________
Baseball
Baseball
Baseball
Baseball
Baseball
10 & under
11 & under*
12 & under
13 & under*
14 & under
M/W
T/Th
T/Th
T/Th
T/Th
$50.00
$50.00
$50.00
$50.00
$50.00
Teams will play on BP & travel to other communities, participate in multiple practices, and
tournaments. Player receives jersey and hat. *Depends on number of registratons.
____________
____________
____________
Softball
Softball
Softball
10 & under
12 & under
14 & under
M/W
M/W
M/W
$50.00
$50.00
$50.00
Teams will play on BP & travel to other communities, participate in multiple practices, and
tournaments. Player receives jersey and visor.
T-Ball & Rookie T-Shirt Sizes (circle)
Youth sizes: S-6/8 M-10/12 L-14/16 XL-18/20
Baseball & Softball Jersey Sizes (circle)
Youth sizes: YS YM YL Adult sizes: AS AM AL AXL
A2XL
Do you give permission for your child to bat in front of a pitching machine with supervision? Yes No
Parent initials__________
Interested in Coaching? Head Coach: Yes No
Assistant Coach: Yes No
Registrations form(s) will be accepted only in person on the 3 Registration Days! (See 11.B & 11.C)
Program Use Only:
Date Paid:___________________________
Family Discount of $100 Applied:
Division Fee: T$30 R$30 BB$50 SB$50
Volunteer Fee: $60 check
Payment: check #________________cash____________ Chicken Q tickets: $32
Y
N
Y
N
$_____ Paid Y
N
Envelope/Paid
$40
$48
1. EMERGENCY RELEASE:
I/We, the parent(s)/guardian(s) of the child named herein, a registered player in the Brice Prairie Youth
Baseball/Softball Program hereby give my/our approval to his/her participation in any and all Brice Prairie
Youth Baseball/Softball Program team activities during the 2014 season. I/We assume risks and hazards
incidental to such participation. I/We do hereby waive, release, absolve, indemnify, and agree to hold
harmless the Brice Prairie Youth Baseball/Softball Program, its teams, the board members, the organizers,
coaches, sponsors, supervisors, participates, and any person transporting my/our child to and from the
activities, except to the extent and in the amount covered by the automobile accident insurance or liability
insurance of said person(s) or organization.
2. I/We state the player named herein has no medical problem(s) or prohibitions except as
listed:_______________________________________________________________________
3. In case of emergency, when parent/guardian is not available, please notify:
Name:_____________________________________________Relationship to player:_________
Home Phone:______________________________Cell Phone:____________________________
4. Our Family Doctor is:_________________________________________________________
[ ] Gundersen Health System, La Crosse (782-7300)
[
] Gundersen Health System, Onalaska (782-1800)
[ ] Mayo Clinic Health, La Crosse (782-9760)
[
] Mayo Clinic Health, Holmen (526-3351)
[ ] Mayo Clinic Health, Onalaska (392-5000)
[
] Other/Phone #:___________________________
5. AUTHORIZATION TO CONSENT TO TREATMENT OF A MINOR:
I/We, the undersigned parent(s)/guardian(s) of the individual named herein, a minor, do hereby authorized
the Brice Prairie Youth Baseball/Softball Program team, as agents for the undersigned, to consent to any
x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital care which is deemed
advisable and is to be rendered under the genteral or special supervision of any physician and surgeon
licensed under the provisions of the medical practice, on the medical staff of any hospital or clinic, whether
such diagnosis or treatment is rendered at said hospital.
It is understood that this authorization is given in advance of any specific diagnosis, treatment or hospital
care being required, but is given to provide authority and power on the part of the aforesaid agents to give
specific consent to any and all such diagnosis, treatment, or hospital care which aforementioned physician in
the exercise of his/her judgment may deem advisable. This authorization is given pursuant to any
provisions existing under the Civil Code of Wisconsin. This authorization shall remain in effect until the
completion of the 2014 season unless sooner revoked in writing and delivered to said agents.
6. PHOTO RELEASE:
I/We, the parent/guardian, of _____________________________________________, do hereby give
permission to the Brice Prairie Youth Baseball/Softball Program to publish my son/daughter's photo on their
website or in a newspapers when applicable.
I also knowingly accept that my son/daughter's name and birth date will be on a published roster and that we
may be asked to provide a birth certificate as proof of age.
Parent/Guardian Signatures________________________________________________________________________________
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7. PARENT/GUARDIAN YOUTH SPORTS CODE OF CONDUCT:
Preamble
The essential elements of character building and ethics in sports are embodied in the concept of
sportsmanship and six core principles: trustworthiness, respect, responsibility,
fairness, caring, and good citizenship. The highest potential of sports is achieved when
competition reflects these "six pillars of character."
I/ We therefore agree:
A. I/We will not force my child to participate in sports.
B. I/We will remember that children participate to have fun and that the game is for youth, not adults.
C. I/We will inform the coach of any physical disability or ailment that may affect the safety of my child or
the safety of others.
D. I/We will learn the rules of the game and the policies of the league.
E. I/We (and my/our guests) will be a positive role model for my child and encourage sportsmanship by
showing respect and courtesy, and by demonstrating positive support for all players, coaches, officials and
spectators at every game, practice or sporting event.
F. I/We (and my/our guests) will not engage in any kind of unsportsmanlike conduct with any official,
coach, player, or parent such as booing and taunting, refusing to shake hands, or using profane language or
gestures.
G. I/We will not encourage any behaviors or practices that would endanger the health and well-being of the
athletes (i.e. heat exhaustion/heat stroke).
H. I/We will teach my child to play by the rules and to resolve conflicts without resorting to hostility,
violence, or bullying.
I. I/We will demand that my child treat other players, coaches, officials and spectators with respect
regardless of race, creed, color, sex or ability.
J. I/We will teach my child that doing one's best is more important than winning, so that my child will never
feel defeated by the outcome of a game or his/her performance.
K. I/We will praise my child for competing fairly and trying hard, and make my child feel like a winner
every time.
L. I/We will never ridicule or yell at my child or other participants for making a mistake or losing a
competition.
M. I/We will emphasize skill development and practices and how they benefit my child over winning.
N. I/We will promote the emotional and physical well-being of the athletes ahead of any personal desire I
may have for my child to win.
O. I/We will respect the officials and their authority during games and will never question, discuss, or
confront coaches at the game field, and will take time to speak with coaches at an agreed upon time and
place.
P. I/We will demand a sports environment for my child that is free from drugs, tobacco, and alcohol, and I
will refrain from their use at all sports events.
Q. I/We will refrain from coaching my child or other players during games and practices, unless I am one of
the official coaches of the team.
Parent/Guardian Signatures_______________________________________________________________________________
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8. 2014 VOLUNTEER SEASON SERVICE HOURS:
A. Each family will be required to volunteer 4 Season Service Hours signed up for the Brice Prairie Youth
Baseball/Softball Program's T-Ball, Rookie, all levels of Baseball, and all levels of Softball divisions. It is the
responsibility of each family to find times to fill there required Season Service volunteer hours. Phone calls will not be
made to recruit for help.
B. A list of Season Service opportunities will be posted on www.volunteerspot.com. It is your responsibility to remember
your volunteer dates, times, and locations. A reminder email may be done prior to the volunteered date/time done by
volunteerspot or reminder/phone call done by a representative of Brice Prairie Youth Baseball/Softball. A family will not
allowed to sign up for any service hours until they have signed and returned the Volunteer Policy form and the required
deposit has been received by Brice Prairie Youth Baseball/Softball. Sign up is on a "first come, first serve" basis.
C. The Brice Prairie Baseball/Softball website (briceprairieball.org) will contain a link to Volunteerspot
and the site will contain the approved volunteer lists. No other jobs, unless approved prior to the act, will be accepted as
Season Service hours or Tournament Service Positions. A coach cannot approve volunteer positions without prior
approval from the board.
D. For Tournament games, no requests will be honored during tournament play for concession placement; if your child is
playing at another field unless the parent has found a reliable adult replacement.
9. 2014 VOLUNTEER SERVICE SEASON FEES:
A. A separate deposit of $60 will be due at the time of registration per family. This check will be kept in a safety deposit
box and will not be cashed during the season. This check will be mailed back to you after August 31st if you have met the
required amount of Season Service hours as applicable. A separate check must be written from the Registration Fees.
B. If a family does not meet the required Season Service hours by the time the season is completed, the check will then be
cashed and deposited into the Brice Prairie Youth Baseball/Softball account after August 31st. If the check is not honored
due to non-sufficient funds, it is the responsibility of the family to cover the dishonored check and any bank charges
assessed to Brice Prairie Youth Baseball/Softball.
C. If only a portion of a family's required hours have been met, the check will then be cashed and deposited after August
31st and a refund of $15.00 per Season Service hour time completed will be returned to each family.
D. If a family has no child playing (i.e. health issues) for the program during the season and the service hours for the
season have not yet been met, the check will be returned to the family upon receiving a written request and a majority vote
by the Board members after the Board's next meeting.
E. A blank envelope will be provided to each family during registration. At that time, an adult family member will print
their address on this envelope and place their check inside the envelope. This will the envelope Brice Prairie Youth
Baseball/Softball places a stamp on and returns to each family after August 31st.
10. 2014 VOLUNTEER SERVICE SEASON REQUIREMENTS:
A. The volunteer job completed will be recorded according to the family's name. Any adult on behalf of that family may
fill a job. Only the family's name listed on Volunteerspot will receive credit for the job worked.
B. Once you have confirmed to a job, it is YOUR responsibility to find an adult replacement for that job in the event you
are unable to fill your scheduled service time. However, prior approval is required if instead of a parent/adult
volunteering; a parent wishes to supervise a child or, if the replacement is under the age of 18 or if there would be
multiple children assisting a parent/adult.
C. When a volunteer has completed their job, they must sign the sign-up sheet posted; please include your email and a
varification email will be sent to that listed email.
D. It is the parent's responsibility to make sure their jobs have been confirmed correctly! If there are any problems found, a
parent should contact the Coordinator or the Brice Prairie Secretary. Appeals must be made within 2 weeks from the date
of service worked or they will not be considered.
E. In the event of inclement weather or unforeseen circumstances, it is your responsibility to report for your scheduled
position or service hours unless you were notified by a Brice Prairie Youth Baseball/Softball representative. A Brice
Prairie Youth Baseball/Softball representative will also notify you either then or at a near future date whether your service
hours or tournament position will be rescheduled to another time. If it cannot be rescheduled, you will receive credit for
your time.
F. Coach's names (3 per team which include 1 head coach and 2 assistant coaches) will be determined at the Coach's
Meeting and/or will be submitted in the beginning of the season prior to 05/15/14 and be approved by the Board.
These coach's names will be posted on the Brice Prairie Baseball/Softball's website. The families in these positions
will automatically fulfill their required Season Service hours for their family's account.
G. If at any time a family cannot fulfill their Season Service Hours due to hardship, a request can be made to a Board
Member and an exemption letter will be reviewed at the Board Meeting and the parent will be notified of the results.
Parent/Guardian Signatures________________________________________________________________________________
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11. Other Items:
A. By registering your child to Brice Prairie Baseball/Softball does not secure a spot on a team. This is not based on
a player's talent but rather the team's structure. If your child does not make it to the roster then a Registration refund
check will sent back along with your Volunteer Season Service check. Decisions will be made by the Board Members
for the Brice Prairie Baseball/Softball by 5/01/14; a letter and checks will mailed after that date.
B. Registrations form(s) by mail will not be accepted. Late Registration form(s) as of 3/23/14 will incur a $15.00
penalty per player; contact [email protected] for enrollment possibilities.
C. If a Registration form is not turned in on the Registration dates and held by coaches until coach's meeting; that
player will not be considered in the 2014 Season. No exceptions! All registrations must be received by the last
registration date.
D. Any requests made by the parents for their player will be taken into consideration but may not be approved (i.e.
car pooling, coach preference, or team player preference).
E. If a parent is requesting their child to play in a division (playing up or playing down); that does not fit with the
player's age. You must fill out a "Play-up Request" or "Other-Play Request" form and submit to a Board Member.
The Brice Prairie Baseball/Softball will notify the parents of the decision. These forms will be available on our
website and on the Registrations dates.
F. We have a ZERO tolerance of Bullying. If your player is receiving bullying; please inform the coach and/or
contact a Board Member (i.e. President of the Brice Prairie Baseball/Softball) for the situation to be dealt with. If
your player is committing the bullying (taunting, name calling, booing) and receives a warning from a member of the
Board of Brice Prairie Baseball/Softball. The negative behavior is at any time or at any location (i.e. school bus,
school, practice, game, etc...). Your player may be suspended or removed from the Brice Prairie Baseball/Softball
Program for the entirety of the season depending on the circumstances deemed by majority vote of the Board
Members. If your player is removed for behavioral reasons; no refunds of any kind will be returned.
G. Brice Prairie Baseball/Softball uses a heat index policy for all of our outdoor practices/games, which you can find
on our website. This policy is addition to any other weather (rain, lightning, etc) policies that are used in the
softball/baseball league. To accommodate travel times, our coaches will have a final decision to cancel games
determined and to the player/parents by 3:00pm for 5:30pm games and 4:00pm for 7:00pm games. For practices or
other activities (camps, scrimmages), the coach will give player and parents one hour minimum notice.
H. Players and their parent/guardian complete the YOUTH PLAYER CODE OF CONDUCT form.
I. Anyone helping with coaching during games or practices; complete the COACH'S CODE OF CONDUCT and
PHOTO RELEASE form.
J. Maximum Registration Fees of $100.00 per family.
K. Mandatory Service Season Volunteer Deposit of $60.00 per family.
L. No Registration Fee Refunds after 4/30/14.
M. Any player leaving after 5/01/14 and before uniforms are given out will not receive the uniform.
N. If a family has a NSF (non-sufficient funds) check and does not reimburse the organization for the amount of the
check along with any bank fees within 60 days of the original check; that family agrees to pay in cash or cashier check
for the remaining seasons the family is enrolled in the organization.
O. All money for Registration and Volunteer hours need to be submitted for a registration form to be
considered. If funds aren't available a post-dated check(s) can be used but not to exceed over 30 days from the last
date of registration (3/10/14).
P. League & Team Placement final as of 5/11/14 for Baseball 10U thru 14U and Softball 10U, 12U, 14U.
Team Placement final as of 5/18/14 for Rookie and T-Ball.
Q. Families must participate in the fund-raising efforts to continue to make Brice Prairie Youth
Baseball/Softball a continued success.
By signing below, I/we understand and give consent to the above mentioned (Items 1 -11).
Parent/Guardian Signatures:________________________________________________________________
Parent/Guardian Printed
Names:_____________________________________________________________
Date:__________________________
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