2024 REP Participation Form (Ingersoll Minor Baseball )
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2024 REP Participation Form
Ingersoll Minor Baseball is hosting tryouts for REP Baseball starting September 13th. Please see website and/or Facebook for additional information. Please complete the participation form prior to coming to a tryout.
Registration form
Player Last Name
*
Player First Name
*
Gender
*
Male
Female
PLEASE PICK ONE
Date of Birth
*
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Email Address
*
Example:
[email protected]
Street Address
*
Town
*
Postal Code
*
Division
*
Utilize 2022 Division Communication Sheet to match birth year to division
Rep
*
YES
NO
Medical Conditions If Any
PARENT INFORMATION
PARENT #1 FULL NAME
*
PARENT #1 PHONE NUMBER
*
PARENT #2 FULL NAME
PARENT #2 PHONE NUMBER
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 imbairo
[email protected]
to have an email id removed from the mail list.
ACKNOWLEDGE USE OF EMAIL
*
YES
NO
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
*
YES
NO
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
*
YES
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
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
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