Spring 2012 Registration Form
Spring 2012 Registration Form
Registration Day: Saturday, February 4th 10am to 2pm Four locations: West Mount Dept (West Mount Dr), West Edgecombe Fire Department (HWY 43) Coopers Volunteer Fire Dept (Volunteer Road) and Sharpsburg Fire Department (Taylor Drive) Step 1: Player/Parent Information __________________________________
Childs Name _______________________________________ School Name Parent or Guardian Name(s) Street Address T-Ball registration (ages 5-8)
________
______________________
Date of Birth (mm/dd/yyyy)
___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Home Phone Business Phone # Cell Phone # Step 2: Program Selection T-Ball registration (ages 5-8) Must not turn 9 yrs old on or before 4/30/12 Early Reg. by 2/4 $40 After 2/4 $45 Step 3:
Shirt: Small(6-8) Medium(10-12) Large(14-16) Youth Extra Large(16-18) Adult Small(32-34) Adult Medium(36-38) Adult Large(40-42) Adult Extra Large (44-46) Hat: Youth Adult Pants (Little League Only): Small(6-8) Medium(10-12) Large(14-16) Youth Extra Large(16-18) Adult Small(32-34) Adult Medium(36-38) Adult Large(40-42) Adult Extra Large (44-46) Extra Shirt Orders: $15 Small(6-8) Quantity:_____ Medium(10-12) Quantity:_____ Large(14-16) Quantity:_____ Adult Small(32-34) Quantity:_____ Adult Medium(36-38) Quantity:_____ Adult Large(40-42) Quantity:_____ Adult XL Quantity:_____ Adult XXL Quantity:_____ Adult XXXL Quantity:_____ Extra Hats: $20 Youth Quantity:_____ Adult Quantity: ______ City State Zip
Little League registration (ages 9-12) Must not turn 13 yrs old on or before 4/30/12 Early Reg. by 2/4 $65 After 2/4 $70
Player Shirt/Hat Size (player shirt/hat included in registration fee for t-ball and full uniform for little league)
Step 4: Returning Players Is your child is a returning player? Yes No Previous Team:_________________ Jersey number:__________
Coach:_______________
Step 5: Coach/Sponsor Interest Are you interested in being a coach or sponsor? Coach Shirt Size: _____ Sponsor Contact Name: ______________________________ Phone Number: ___________________ Step 6: Consent & Waiver of League Liability I hereby consent for my child above, to participate in the Tri-Community Baseball League. I release team sponsers, league sponsors and league officials (including coaches) from any claim that may arise from injuries suffered by my child while participating in league activitites (games, practices etc.). _______________________________________________________________________ (Parent or Guardians Signature) Date Registration form and fee are required by registration deadline February 25, 2012. Please make all checks payable to Tri-Community Baseball League. You can combine extra shirt/hat orders and your registration fee in one check. Payment for extra shirts/hats is required at registration in order to receive prior to the season. Tri-Community Baseball League 1228 Bullock School Rd Rocky Mount NC 27801 With questions contact: Erica Webb Home 252-623-7669