WEST COBB BASEBALL ASSOCIATION

AMOUNT______
AMOUNT______CASH OR
CHECK#______
REC.BY______
Date :______
HIGH SCHOOL AFFILIATION:
______
What grade is child in? ______

1720 MARS HILL ROAD

SUITE 8 – BOX 133
ACWORTH, GA 30101

Visit us at

Player and Guardian/Parent Information:

Player Name (First & Last): / Date of Birth: / Home Phone #: / Age as of April 30,2018
Address: / City: / County / Zip:
Positions Played 1B 2B 3B SS P
Please Circle LF CF RF C / Years Played
in High School: / Years Played
in Travel Ball: / Years Played
in All-stars:
*In compliance with Georgia House Bill 489; Do you pay Cobb County property tax? YES______NO______
THERE WILL BE AN ADDITIONAL $25.00 CHARGE FOR NON COBB COUNTY RESIDENTIAL PLAYERS
Father or Guardian: / Work#: / Mother or Guardian: / Work#:
E-mail Address: / Cell Phone #: / E-mail Address: / Cell Phone #:
Doctor’s Name: / Phone#: / Is there a medical history we should be aware of?
In case of emergency contact: / Phone#: / Emergency Phone #: / Contact Lenses? (Yes/No)

**Coach, Sponsor or Volunteer Information:

WE NEED YOUR HELP!! PLEASE CHECK THE FOLLOWING AREAS THAT YOU ARE WILLING TO HELP:

Team Manager ____ Coach ____ Team Father ____ Team Mother____ Board Member _____ Concessions______

Would you, or your company, be interested in becoming a Sponsor for WCBA? All monies collected from Sponsorships are TAX DEDUCTIBLE and used to improve the Park Facilities.
YES!! Please contact me about becoming a Sponsor for WCBA ______

General Release, Waiver of Liability and Hold Harmless Agreement:

I/we, hereafter referred as ‘Guardian’, hereby give our consent and approval for the above named child’s participation in this program. Guardian recognizes and assumes all risks of injury and hazards incidental to the above named child’s participation in organized baseball. In and for consideration of the above named child being allowed to participate in the program, Guardian hereby releases West Cobb Baseball Association (WCBA); the WCBA officers, board members, sponsors, coaches, and other supervisors; and agree to indemnify and hold said parties harmless from any and all claims, losses, demands, liabilities, or causes of action arising out participation in this program, specifically including, but not limited to, bodily and personal injuries sustained by the above named child while participating in the program. Guardian further agrees to abide by the WCBA bylaws. Guardian gives permission for the transportation of the above named child to the hospital or doctor in the event of an injury.
Parent or Guardian ______
(Signature) (PLEASE Print Mother & Fathers first name)
WCBA encourages all families to complete the registration process on-line @ our website link, THE REGISTRATION FEE NO LONGER INCLUDES PANTS!
No refund will be given after skill testing date of respective age group; unless your child is named to the official spring high school roster. To receive a refund, the WCBA president must be contacted by phone, Bill Jones (404-259-7629) if you need to cancel your registration prior to skills test please contact the league director for your age group. All refunds will have a $25 administrative fee withheld.

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