Registration 2021 (Ingersoll Minor Baseball )

Registration form

Player Last Name ^*
Player First Name ^*
Gender ^*
Male Female
PLEASE PICK ONE

Date of Birth ^*

Email Address ^*

Example: [email protected]
Street Address ^*
Town ^*
Postal Code ^*
Division^*

Utilize2021 Division Communication Sheet to match birth year to division
Rep^*
YESNO
Played in 2019 or 2020 ^*
YES NO
House League Uniform Shirt Size
YOUTH SMALL
YOUTH MEDIUM
YOUTH LARGE
YOUTH XL
ADULT SMALL
ADULT MEDIUM
ADULT LARGE
Please pick one size only
Are you interested in playing girls Fastball
YESNO
Notes

Any additional information not captured above
Medical Conditions If Any
Payment Method Preference ^*
Cash
Cheque
Etransfer
Debit
Credit Card
2020 Credit
Payment Due Date Communication to come in late Feb

PARENT INFORMATION

PARENT #1 FULL NAME ^*
PARENT #1 PHONE NUMBER ^*
PARENT #2 FULL NAME
PARENT #2 PHONE NUMBER

Team Coaching

The minor baseball program relies on volunteers to coach our teams as without coaches, there is no program. Please consider volunteering to coach and support our youth.Head Coaches will receive 1 childs registration fees waived for the current season. If there are multiple coaches who apply for a team the 2021 Executive Team will select Head Coaches

I am interested in Coaching
YESNO
Last Name
First Name
Email Address

Example: [email protected]
Phone number

Example: ###-###-####
Phone number #2

Example: ###-###-####
Division
Uniform Size
ADULT SMALL
ADULT MEDIUM
ADULT LARGE
ADULT XL
ADULT XXL
ADULT XXXL

USE OF EMAIL ID

USE OF EMAIL ID: The email id(s) provided above will be used for player and/or coach communication by IMBA and coaches throughout the baseball season. Please notify the IMBA Executive via the IMBA email address [email protected] to have an email id removed from the mail list.

ACKNOWLEDGE USE OF EMAIL^*
YESNO
ACKNOWLEDGE THE USE OF YOUR EMAIL ADDRESS FOR IMBA TO COMMUNICATE SEASON EVENTS TO

PARENT GUARDIAN CONSENT

Over the course of the baseball season, player names (including team lists) are included on the IMBA website, public IMBA displays and possibly newspaper publications. Additionally, throughout the baseball season, individual and team pictures and videos are taken at various IMBA events (and may be used beyond the current year). Your permission is requested to use your child's full name and photographs/videos

PERMISSION GRANTED ^*
YESNO

RELEASE AND DISCHARGE ACKNOWLEDGEMENT

RELEASE AND DISCHARGE (please read carefully) In consideration of accepting the above-mentioned person, I grant him/her permission to participate in the Ingersoll Minor Baseball program(s). For the same consideration, I hereby release and forever discharge Ingersoll Minor Baseball Inc. (IMBA), its Officers, Directors, Conveyors, Coaches, Umpires or other Officials and the Town of Ingersoll from all claims, demands, damages, actions or causes of action arising or to arise by and reason because of my son's/daughter's participation in any Ingersoll Minor Baseball program, in this or any successive years(s), including (but without limiting the generality of the foregoing) any and all dental and medical bills and further of and from all claims or demands whatsoever in law or in equity which I, my heirs, executors, administrators or assignors can, shall or may have by reason aforesaid.

RELEASE AGREED TO ^*

ROWANS LAW

ROWAN'S LAW: Rowan's Law (Concussion Safety), is mandatory for sports organizations to: ensure that athletes under 26 years of age,* parents of athletes under 18, coaches, team trainers and officials confirm every year that they have reviewed Ontario's Concussion Awareness Resources. This Form MUST be completed by all players, coaches and umpires. To find Rowan's Law on our website please go to our home page-links, Rowan's Law https://tinyurl.com/y4bjsnlf

I HAVE READ AND ACKNOWLEDGE ^*
YES

PARENT CODE OF CONDUCT

Please Read the Parent Code of Conduct found under Rules-on our homepage then click box to confirm that you have read and understood this form.

Yes I have read the Parent Code of Conduct^*
YES

PLAYER CODE OF CONDUDT

Please take the time to review with your player . Player Code of Conduct is found in our On Line Forms

I have read Player Code of Conduct and agree to apply
YES

MEDICAL ATTENTION PERMISSION

All players will wear the uniform of IMBA, and will act in accordance with the Players and Parent Code of Conduct I hereby grant permission for my child to play in the Ingersoll Minor Baseball Association I understand that IMBA will not assume any responsibility for any injury that happens I further give permission for IMBA to take my child to the hospital in the event of an emergency

I ACKNOWLEDGE AND AGRE
YES

Human Validation

Check The Box ^*