Waiver Homework

Please check activities you are registering for: Age Control Date for Softball is December 31, 2017 Age Control Date for Baseball is April 30, 2018 Age Control Date for Soccer is July 31, 2018 � Baseball – TBall 4 year olds COED $55 � Softball – 5-6 Girls $60 � Baseball – 5-6 Boys $60 � Softball – 7-8 Girls $70 � Baseball – 7-8 Boys $70 � Softball – 9-10 Girls $70 � Baseball – 9-10 Boys $70 � Softball – 11-12 Girls $70 � Baseball – 11-12 Boys $70 � Soccer – 4-5 COED $50 � Baseball – 13-14 Boys $70 � Soccer – 6-7 COED $65 � Soccer – 8-9 COED $65 � Soccer – 10-13 COED $65 Participants must meet Morgan County residency requirements. A $25 fee will be added for all Non-Morgan County residents. A $10 "late" fee

will be added for registration after the deadline. Please Print Clearly Participant’s Name

Parent E-mail address

Address City State Zip

Home Phone Work Phone

Mother’s Name Cell Phone

Father’s Name Cell Phone

Emergency Contact Phone

Date of Birth / / Age Sex Grade School

Medical Conditions/Allergies Current Medications

Sibling Name – If in the same league

Would a parent like to be a COACH? � Head Coach � Assistant Coach � No If you would like to coach, provide name: Jersey Size – Circle One: Youth: Small Medium Large Adult: Small Medium Large X-Large Pants Size – Circle One: Youth: Small Medium Large Adult: Small Medium Large X-Large Parent Information Orientation : One parent/guardian has completed the required Parent Information Orientation? � Yes � No If yes, the Orientation was under the following name (Print Name) : If no, I understand that I must complete the Parent Information Orientation prior to the season for my child to participate. By signing below, I agree to complete the Parent Information Orientation program and follow the Parents’ Code of Ethics. Concussion Policy: In order to register, parents must initial here ___________ to confirm the following: � I, the parent/guardian hereby acknowledge receiving concussion information. � I accept my responsibility to report my child’s symptoms to MCRD staff, coaches, and health care providers. � I understand that my child must not have any concussion symptoms before returning to play and must have written permission from

a health care provider trained in concussion management before returning to play. Refund Policy: Full refunds will be given prior to the team programs start (i.e. division of teams, ordering of uniforms, etc.) less a $5.00 service charge. 50% refunds will be given after the athletic program has started but no games have been played and equipment has been returned. Exceptions: No refund equal to the cost of any special order of sized uniforms (example: Cheer uniform). No refund will be given after a game has been played. Parent/Guardian Signature Date

2018 Spring – Baseball/Softball/Soccer Participant Registration Form

OVER

PARTICIPANT WAIVER & RELEASE OF LIABILITY

MUST BE SIGNED TO PROCESS REGISTRATION

In consideration of the named participant being allowed to participate in any way in the Morgan County Parks and Recreation Department programs, related events and activities, I, the parent/ legal guardian, of the named child, or as an adult participant, hereby acknowledges, appreciates, and agrees to the following: 1. The risk of injury or damages to my child and/or myself from the activities involved in the programs is significant,

including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2. FOR MYSELF, SPOUSE AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and

unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child’s participation; and,

3. I myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives, and next of kin,

HEREBY INDEMINFY AND HOLD HARMLESS the Morgan County Board of Commissioners, and all employees or agents of Morgan County, including all individuals who are affiliated with the programs administered by the Parks and Recreation Department of Morgan County (“Releases”), from any and all liabilities incident to my involvement or participation in these programs or transportation to and from activities, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASES OR OTHERWISE, to the fullest extent permitted by law.

4. I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives, and next of kin,

HEREBY RELEASE THE other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event, WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my and/or my child’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

5. I hereby grant consent to any and all first aid responders designated by the Morgan County Parks and Recreation

Department to provide my child any necessary medical care as a result of any injury/illness. This consent includes First Aid and transportation to/from first aid responders.

6. I further understand that health or accident insurance which would cover my or my child's medical, hospital, or related

expenses in the event of injury in this activity is my responsibility. I understand the Parks & Recreation Department of Morgan County strongly recommends that if I do not have sufficient insurance to cover such incidents that I should take the necessary action to obtain it.

7. I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe

any unusual significant concern in my or my child’s readiness for participation and/or in the program itself, I will remove myself or my child from the participation and bring such attention of the nearest official immediately; and,

8. I understand that I am bound to abide by the Morgan County Parks & Recreation Department's Code of Conduct. I

further understand that these programs are recreational and that if either parent should exhibit continued unsportsmanlike conduct, the child may be removed from the program.

9. I understand that the department may use participant images or videos, and that such may be published in an outlet

used to promote or publicize the program or department. 10. In addition, I understand that it is mandatory for a parent of all competitive youth sports participants to complete the

Parent Information Orientation training before their child can participate in a youth sports program.

I HAVE READ THIS RELEASE OF LIABILITY, ASSUMPTION OF RISK AGREEMENT AND WAIVER. I FULLY UNDERSTAND ITS TERMS, I UNDERSTAND I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. Parent/Guardian Signature Date