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T-Ball Registration
*
Indicates required field
Child 1
*
First
Last
Required
Age
*
Birthdate
*
Grade
*
Gender
*
Choose One
Male
Female
T-shirt Size
*
Child 2
*
First
Last
Age
*
Birthdate
*
Grade
*
Gender
*
Choose one
Male
Female
T-Shirt Size
*
Choose one
Youth Small (6-8)
Youth Medium (10-12)
Youth Large (14-16)
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult 2X-Large
Child 3
*
First
Last
Age
*
Birthdate
*
Grade
*
Gender
*
Choose one
Male
Female
T-Shirt Size
*
Choose one
Youth Small (6-8)
Youth Medium (10-12)
Youth Large (14-16)
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult 2X-Large
Child 4
*
First
Last
Age
*
Birthdate
*
Grade
*
Gender
*
Choose one
Male
Female
T-Shirt Size
*
Choose one
Youth Small (6-8)
Youth Medium (10-12)
Youth Large (14-16)
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult 2X-Large
School
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Required
Please list any physical, learning, or emotional challenges or limitations and/or medications the coaches need to know about.
*
Please list any physical, learning, or emotional challenges or limitations and / or medications the coaches need to know about.
Primary Contact
*
Required
Relationship
*
Required
Phone Number
*
Required
Email
*
Secondary Contact
*
Relationship
*
Phone Number
*
Email
*
Volunteer Support
*
Choose one
Coach
Assistant Coach
Team Parent
Everyone MUST choose an option and volunteer to support their child's team.
Sponsorship ($200.00) - if yes, please include name and contact information
*
Choose one
Yes
No
Sponsor Name & Contact Information
*
Consent for Participation
I, the parent/ guardian of the registrant, a minor, agree that the registrant and I will abide by the rules/ guidelines of the HCC it’s affiliated organizations and sponsors. I recognize the possibility of physical injury
or illness from exposure to any bacteria, fungus, virus, unknown contagious diseases or COVID-19
associated with the indoor soccer program and in consideration for the HCC accepting the registrant for its programs and activities, I hereby release, discharge and or otherwise indemnify the HCC, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of facilities utilized for the program against any claims by or on behalf of the registrant as a result of the registrant’s participation in the program and or being transported to or from the same, which transportation I here-by authorize.
Further permission must be granted by the HCC for the registrant without insurance coverage to participate.
Signature / Name
*
Required
Consent for Minor Medical Treatment
As a parent or legal guardian of the above participant, I hereby give my consent for emergency medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry . This care may be given under whatever conditions are necessary to preserve the health and safety of the participant.
Signature / Name
*
Required
Date
*
Required
Medical Insurance
*
Choose one
Yes
No
Required
Doctors Name
*
Required
Phone
*
Required
(Participation will not be denied based on whether or not participant is insured)
Photo/Video Consent
I/We grant permission for my child to have his/her photo/video taken and published on the HCC Programs public internet site or any other type of media.
Photo/Video Consent
*
Choose one
Yes
No
Required
Submit
Home
About Us
Facilities
>
Rental Information
Board of Directors
History
Programs
Basketball
Camp HCC
Education Programs
Fall Soccer
Gymnastics
Indoor Soccer
Pickleball
Play Day
Roller Skating
Swimming - Summer
Swimming - Winter
T-Ball
Track and Field
Uptown Playground
Donations
Volunteers
PA Clearances
Craft Fair
Scholarship Program
Rental Information
Gymnastics