Participant:

Last Name

First Name

Address

City

Zip Code

DOB

 

Using the address above, is Hammonton High School the public school sending district?

Yes No

Please pick one: Boy Girl

    

Parent or Guardian:

Last Name	First Name
Home Phone	Cell Phone

Email Address

 

Does the participant have any medical conditions of which the coaches should be made aware? 

Yes

No

    (If yes, please complete the medical information form below)

 

Emergency Contacts (2): 

Name	Phone
Name	Phone

 

Please put an X in one of the following:

T-Ball Boys & Girls

Players must be 4, 5or 6 years old on October 1, 2012

 

2012 SEASON FEES

*** When you play Spring Softball with Folsom, you also get to play Fall Ball with Folsom at no additional charge.  You get 2 SEASONS out of 1 FEE. ***   Also, if your child did not play Spring Softball with Folsom but did play Fall Ball with Folsom, you will have a $55.00 credit on your registration.  Please remember that although a spot on a team has been reserved for your child, it is not confirmed until the balance of $45.00 is paid to the FAA.

Please pick one.

Softball – 1st child - $80.00
                  2nd child - $50.00
                  3rd child - $50.00
               

I would like to help in the area(s) I have put an X below:

Manager

Team Parent

Field Care

Funraising

Coach

Other

 

THERE IS A POSSIBILITY OF THE FOLSOM TEEBALL PROGRAM PLAYING FALL

TEEBALL WITH OTHER AREA TOWNS.  Please indicate whether or not you would like

your child to participate in any Fall TeeBall program offered by Folsom.  More information

will be provided during the Spring season.

 

Yes I am interested in my child playing Fall Teeball

No I am not interested in the Fallball program

 

*** I HEREBY AGREE AND UNDERSTAND THE FOLLOWING ***
1.  Uniforms: The uniform(s)  (T-Ball pants) is the
      property of the FAA and is to be returned to the FAA by the end of the season.  If  the
      uniform is not returned by said date, I will be assessed a uniform deposit in the following
      season.  If my child will be too old to play the following season, I have to pay the cost of a
      new uniform.

 

2.  Concession Stand and/or Field Clean Up Day: I am not required to work the concessions    
      stand nor participate on field clean up day however, the FAA would be very appreciate of any and all
      assistance with field day and the concessions stand.

I accept these conditions

Parent/Guardian Name

Date

Birth Certificate must be turned in if we do not have it on file.

 

Folsom Athletic Association Medical Information Form

Child’s Name

Existing Conditions:

Does the participant have any existing injuries, illnesses, or allergic conditions in which the coaching staff needs to be aware?  Please explain.

Existing Conditions

In my absence, in case of emergency, use this form for information only.

This does not authorize medical treatment for more than emergency care.

Parent’s Name

 

My child is covered under the following family medical insurance:

POLICY No.:
SUBSCRIBER:
INSURANCE COMPANY: