Fall 2022 Town of Orleans Youth Commission Signup Form

Town of Orleans Youth Commission Basketball 2022
We are currently holding sign ups for t-ball, softball, & baseball.
Child Name*

First NameLast Name
Current Grade*
Date of Birth*

MonthDayYear
Age *
Gender*

MaleFemale
Jersey Size*

YSYMYLYXLASAMALAXL
Parent's Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Alternate Number

Area CodePhone Number
E-mail
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Medical Conditions or Allergies
I give permission for my son/daughter to receieve emergency medical treatment administered by coaches or Youth Commission Volunteers. In an emergency, if I, the parent or guardian can't be reached, please contact:
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Parent/Guardian Signature (by filling out this field you are signing and agreeing to the above*

First NameLast Name
I agree to return all equipment/uniforms issued to my child. I understand that I am responsible for repairing or replacing the equipment/uniforms if it is damaged, lost or stolen while in my possession. I understand uniforms are the property of TOYC.
Parent/Guardian Signature (by filling out this field you are signing and agreeing to the above*

First NameLast Name
I hereby grant TOYC permission to take and use photographs of my child in any and all of its publications and in any and all other media.
Parent/Guardian Signature (by filling out this field you are signing and agreeing to the above*

First NameLast Name
Teams exist with the contingency that a parent or volunteer is willing to accept the coaching challenge.
I am willing to help:

CoachVolunteer
Should be Empty:

Town of Orleans Youth Commission Basketball 2022