Texas Raptors2009 Fall Registration Form

.

Registration Fees
9U Team Fees / $300.00
9U Coach Fees / $50.00 Monthly
8U Team Fees / $300.00
8U Coach Fees / $50.00 Monthly
  1. Make checks payable to Texas Raptors (for 9U or 8U)
  2. Refund Policy 50% refund prior to 9/7/09. No Refund after 9/7/09 ______INIT.

–

Please Print:

Players Last Name: ______First Name:______DOB:______

Street Address______Home Phone______

City/State/Zip ______

Fall 2009 Grade: _____Fall 2009 School ______

Age as of 9/1/2009 ______

Please check appropriate box

8U 9U
CAMP2 weeks 1 week N/A
Parent/Guardian Emergency Contact Information (please be complete as possible)
Parent / Guardian 1
Full Name / Parent / Guardian 2
Full Name
Relationship to Player / Relationship to Player
Home Phone / Home Phone
Cell Phone / Cell Phone
Email Address / Email Address
Medical Information
Physician / Family Doctor
Doctor’s Phone
Insurance Carrier
Policy Number
Medical History (Allergies, Medications, Special Conditions, etc.)

IMPORTANT NOTE: If the player is under medical care or is on prescribed medication, a note from his/her physician is required

PARENT PERMISSION

Parents please initial for permission

My child’s photo may be used in Texas Raptors publications, press releases, or web pages

My child’s name may be used in Texas Raptors publications, press release, or web pages

Players will not be allowed to participate in the Texas Raptors program if payment is not paid in full. Fees include team uniforms, tournament, and the 9u coach. Other fees may apply for the use of fields, batting cages & coach traveling expenses. Fundraisers & Sponsorship Opportunities will be offered as an option to help offset “other fees”.

Medication Authorization – Grant of Consent: I hereby certify that my child is in good health and may participate in all activities. In case of an emergency, I give my permission for my child to be given emergency treatment at any responsible accessible hospital.

Liability Waiver: AS the parent (or legal guardian) of the above named minor, I grant permission for the minor to participate in all activities of the sports program. I assume all risk and hazards incidental to such participation, including transportation to and from such activities, and do hereby release and waive all claims against Texas Raptors baseball & Seraphim Community Outreach Inc. and it’s affiliates, including Sponsors, volunteers, agents and other participants.

Signature of Parent / Guardian ______

Print Name ______Date ______

Texas Raptors Use / Check No. / Amount Paid / Date Received
Texas Raptors Use / Check Box For
Copy of birth certificate. / Date Received