IMANI TEMPLE T-BALL LEAGUE

REGISTRATION FORM

Registration Fee: $35 per child

Due by May 25, 2025

Player Information

Player Name*

First NameLast Name

Guardian / Parents Names*

First NameLast Name

Guardian / Parents Names*

First NameLast Name

Address*

Street Address

Street Address Line 2

City

Postal / Zip Code

Home Phone*

Format: (000) 000-0000.

Cell Phone*

Format: (000) 000-0000.

Birthday*

Age*

Sex*

E-mail*

example@example.com

Emergency Contact & Health Insurance Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Format: (000) 000-0000.

CoachAssistant CoachUmpire

T-shirt size*

Parental Permission For Emergency Treatment

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child, and I authorize the person in charge to take my child to:
I give consent for the facility to secure any and all necessary emergency medical care for my child.

Name of Physician / Emergency Medical Care Facility*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Allergies?

Phone Number*

Format: (000) 000-0000.

Waiver/Liability

I, the parents/guardians of the above-named player for the Imani Temple #49 T-Ball team, hereby give my approval to participate in any and all Imani Temple #49 T-Ball activities.

I know that participation in T-Ball may result in serious injuries and protective equipment does not prevent all injuries to players. I hereby waive, release, and agree not hold Imani Temple #49, the organizers, sponsors, supervisors, coaches, participants, and persons transporting my child to and from activities from any claim arising out of any injury to my child whether the result of negligence or for any other causes.

Photo Release/Waiver

With my signature below I grant permission for my child(ren) to be photographed, or their images recorded for print or electronic use in promoting the Imani Temple#49 T-Ball League. I understand that it is my responsibility to update this form in the event that I no longer wish to authorize the above uses. I agree that this form will remain in effect during the term of my child’s enrollment. I understand that there will be no payment for me or my child’s participation in this release.

Sportsmanship/Behavior

I agree to carry myself and any guests in a respectful manner. I will participate in good sportsmanship and will not interrupt play or partake in obscene gestures or language while on Imani Temple # 49 property. I understand that if I disrupt any activities that I can be removed and banned from the premises.

YesNo

Parent's Signature*

My Products

Registration Fee

$35.00

$35.00 Quantity

Total

$0.00

Payment Methods

Credit Card

Cash App Pay