Spring 2022 Softball Registration

Today's Date

Date

Which sports are you signing up for today? *

Softball (ages 5 - 12; age as of September 1, 2022) - $60 Each

How many children playing softball? *

AGES 5-12

Softball Player's Name *

First Name Last Name

Softball Player's Birthday *

Date

Softball Player's Age as of September 1, 2022 *

Softball Player's Gender *

Female

Softball Player's Shirt Size *

Softball Player's Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Softball Player's Residency *

County City

2nd Softball Athlete's Name *

First Name Last Name

2nd Softball Player's Birthday *

Date

2nd Softball Player's Age as of September 1, 2022 *

2nd Softball Player's Gender *

Female

2nd Softball Player's Shirt Size *

3rd Softball Athlete's Name *

First Name Last Name

3rd Softball Player's Birthday *

Date

3rd Softball Player's Age as of September 1, 2022 *

3rd Softball Player's Gender *

Female

3rd Softball Player's Shirt Size *

4th Softball Athlete's Name *

First Name Last Name

4th Softball Player's Birthday *

Date

4th Softball Player's Age as of September 1, 2022 *

4th Softball Player's Gender *

Female

4th Softball Player's Shirt Size *

Parent/Guardian #1 Information

Name *

First Name Last Name

Home Number

Area Code Phone Number

Cell Number *

Area Code Phone Number

E-mail (if no e-mail address, enter no@no.com) *

Parent/Guardian #2 Information

Name *

First Name Last Name

Home Number

Area Code Phone Number

Cell Number *

Area Code Phone Number

E-mail (if no e-mail address, enter no@no.com)

example@example.com

Emergency Information

Emergency Contact's Name *

First Name Last Name

Relationship *

Phone Number *

Area Code Phone Number

Alt. Phone Number

Area Code Phone Number

Phone Number - to be used to receive text messages from the Cedartown Recreation Department about the season: *

Area Code Phone Number

Phone Number - to be used to receive text messages from the Cedartown Recreation Department about the season:

Area Code Phone Number

Does the athlete have any allergies, chronic illness, or medical conditions? If yes, please describe. *

Is the athlete prescribed an inhaler? If yes, please explain any instructions. *

Parents Code of Ethics

I will encourage good sportsmanship by demonstrating positive support for all players, coaches, and officials at every game and practice.
I will place the emotional an dphysical well-being of my child ahead of my personal desire to win.
I will insist that my child play in a safe and healthy environment.
I will insist that my child's coach be trained in the responsibilities of being a youth sports coach and that the coach upholds these CRD Code of Ethics.
I will support coaches and officials working with my child in order to encourage a positive and enjoyable experience for all.
I will demand a sports environment for my child that is free from drugs, alcohol, and tobacco and will refrain from their use while at all CRD youth events.
I will remember that the game is for the youth, not the adults.
I will do my very best to make youth sports fun for my child.
I will ask my child to treat other players, coaches, fans, and officials with respect regardless of race, sex, creed, or ability.
I will require all who come to watch my child participate in any CRD youth sports program to follow this CRD Code of Ethics.

Assumption of Risk and Waiver of Liability for COVID-19

The City of Cedartown has put in place preventative measures to mitigate the spread of COVID-19; however, the City cannot guarantee that anyone you are legally responsible for or yourself will not become infected with COVID-19 by participating in a City sponsored activity or utilization of a City facility. Further, attending City sponsored activities could potentially increase risk of contracting COVID-19.

By electronically signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that those I am legally responsible for and myself may be exposed to or infected by COVID-19 by attending City activities or utilization of City facilities and that such exposure or infection may result in personal injury, illness, permanent disability, and/or death. I understand tgat tge rusj if becoming exposed to or infected by COVID-19 at City activities and utilization of City facilities may result from the actions, omissions, or negligence of myself and others, including but not limited to City employees, volunteers, and program participants and their families.

I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to those I am legally responsible for and myself, including but not limited to, personal injury, disability, death, illness, damage, loss, claim, liability, or expense of any kind, that I or the party I am responsible for may experience or incur in connection with mine or his/her participation in City activities or utilization of City facilities. On my behalf of those I am legally responsible for, I hereby release, covenant not to sue, discharge, and hold harmless and idemnify the City, its employees, agents, and representatives, of and from any and all claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the City, its employees, agents and representatives, whether a COVID-19 infection occurs before, during, or after participation in any City activity or utilization of a City facility.

i further agree to take all steps necessary to comply with the Executive and Emergency Orders issued by the World Health Organization, the Federal Government, the State of Georgia, and the City of Cedartown.

Medical Release and Authorization

As Parent and/or Guardian of the named athlete, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named athlete. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

Permission is also granted to the City of Cedartown . and its affiliates including Directors, Coaches, and Team Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility.

Release authorized on the dates and/or duration of the registered season.

This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

***BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.***

Signature *

Clear

Calculated Total:

Your registration total is... *

USD This is the amount you will be charged. If the amount input does not match the calculated total then you will void your registration.

Credit Card

Note:

Payment must be made at time of registration.
Refund Policy: Registration refunds must be submitted by completing Refund Request Form with an administrator from the recreation department. A $5 administrative fee will be deducted from your refund. Once the athlete's jersey has been ordered, refunds will no longer be available.

Cedartown Recreation Department Spring 2022 Softball Registration

Athlete Information

Credit Card