J-Ball Registration

Choose a Sport:

Name

First NameLast Name

Gender

Date of Birth

Date

Grade of Child

Uniform Shirt Size

May we use photos of your child for promotional purposes?

Extra notes about your child:

Special Needs or Extra Information

Name of Parent/Guardian

First NameLast Name

Parent/Guardian Email

example@example.com

Parent/Guardian Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Relationship to Athlete

Secondary Contact Name

First NameLast Name

Secondary Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Secondary Relationship to Athlete

We need volunteers to help with our league. Please let us know if you are interested in helping. Select from the choices to help in that area

Name of Interested Volunteer

First NameLast Name

Are you a member of a Church?

Where do you attend Church?

I, the parent/gaurian of the athlete, a minor, agree that I and the participant will abide by the rules of the J-Ball Program at South Seminole Baptist Church. I assume full responsibility of all risks, hazards, and costs incidental to participation in the program including transportation to and from all activities. I do hereby waive, release, and agree to hold harmlessly the church, league officials, and other parties designated for the claims from injury to them while in this outreach program.

Signature & Date

Due to the outbreak of the novel Coronavirus (COVID-19), South Seminole Baptist Church is doing everything we can to protect you, our members, our community and our staff. To this extent, South Seminole Baptist Church will be following the Center of Disease-Control (CDC) with regard to social distancing practices and sanitation. We ask that our athlete disclose their health history and continue to implement these sanitation and disinfection procedures.

Symptoms of COVID-19 include:

-Fever

-Fatigue

-Dry Cough

-Difficulty Breathing

I agree to inform the J-ball league officials and/or coach if my child or I am feeling any of the symptoms listed above. I agree to stay home if I am aware, if I or my child were exposed to COVID-19. I agree to stay home if I, my child, or a member of my household is diagnosed with COVID-19.

In signing this form you acknowledge that you may be exposed to COVID-19 at any group gathering and you release all liability. South Seminole Baptist Church will not be held liable from any exposure to the Coronavirus (COVID-19).

Signature & Date

SSBC J-Ball Registration