Falls church/annandale babe ruth



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FALLS CHURCH/ANNANDALE BABE RUTH


REGISTRATION INSTRUCTIONS AND FORM
FCABR SPONSORED LEAGUES:

FCABR Prep League Instructional league just for 13-year-old players.
FCABR d

American Leagues For 14- and 15-year-old players –includes High School players wanting to play after H.S. season ends.
FCABR Senior League For 16-, 17, 18 & 19-year-old players – includes High School players wanting to play after H.S. season ends.
REGISTRATION FEES:*
$190 for one player

$25 family discount for each family member after first



* Financial Aid is available for those who are in need. Please contact the President at fcababeruth@gmail.com. All requests will be kept in the strictest of confidence.
HOW TO REGISTER:


  • By-mail using this mail-in registration form (print pages 2 and 3 of this document)



  • On-line registration is also available on our web site


REGISTRATION CLOSING DATES:*

FCABR Prep League March 15th

FCABR 14-/15-year-olds March 21st

FCABR Senior League April 19th



* Registrations received after the closing date will be wait-listed and participation in the 2013 season cannot be guaranteed. JV and Varsity Players, do not delay – registering in no way affects your high school eligibility.
1.

FALLS CHURCH/ANNANDALE BABE RUTH

(2014 Spring Season)


Registration for FCABR league

PART 1 – PLAYER DATA

___________________________________________________________________________________________

LAST NAME FIRST NAME MI
___________________________________________________________________________________________

STREET ADDRESS CITY ZIP CODE


___________________________________________________________________________________________

TELEPHONE #HOME CELL# BIRTH DATE PLAYER’S GRADE


___________________________________________________________________________________________

PARENTS’ NAMES best e-mail address PLAYER’S SCHOOL


# YEARS PRIOR BASEBALL EXPERIENCE: ______ BEST POSITION (S)PLEASE RANK

IN ORDER WITH 1 AS BEST, ETC.



LEAGUE PLAYED IN LAST SEASON:

Falls Church/Annandale Babe Ruth ______ ( ) PITCHER

Annandale/North Springfield Little League ______ ( ) CATCHER

Falls Church/Kiwanis Little League ______ ( ) INFIELD

Mason District Little League ______ ( ) OUTFIELD

Other League (please specify): ______________________________________



PART 2 – VOLUNTEER SERVICES

PLEASE INDICATE BELOW WHICH OF THE FOLLOWING VOLUNTEER POSITIONS YOU, AS A PARENT OR GUARDIAN, WOULD BE WILLING TO FILL TO HELP THE PROGRAM THRIVE.



OPERATIONAL PROGRAMS: VOLUNTEER LIST:

( ) CONCESSION STAND MANAGEMENT ** ( ) MANAGER

( ) TEAM SPONSOR ($300) ** ( ) COACH ( ) ALL STAR TOURNAMENT DIRECTOR ** ( ) SCOREKEEPER ( ) BOARD OF DIRECTORS ** ( ) TEAM PARENT

( ) LEAGUE PICTURES ** ( ) FIELD MAINTENANCE


Per Fairfax County field allocation policies, registration information for each participant is provided to the Fairfax County Department of Community and Recreation Services (DCRS). Once DCRS receives this information, it becomes public record and may be released under the Virginia Freedom of Information Act unless the parent/guardian specifically requests that this information not be released. Please indicate whether you want to grant DCRS permission to release your child’s registration information. ( ) YES, information may be released ( ) NO, do not release information

2.

PART 3 – MEDICAL TREATMENT FORM

I/We hereby expressly authorize and request Fall Church/Annandale Babe Ruth Association (FCABR) to use their best judgment in any emergency situation requiring paraprofessional or professional medical attention or treatment in the event I/we am/are not available or cannot be reached. I/we will not be at all practices and games. Therefore, I/we will complete the below “Medical Release Form” which will be given to the Manager/Coach at the start of the season. I/we understand that if I/we do not complete the below form, I/we must be at each practice and game for my son/daughter to participate in case my child requires emergency medical treatment.



AUTHORIZATION FOR EMERGENCY TREATMENT
I, ___________________________, as parent/guardian of __________________________, hereby

authorize any state-licensed medical facility to render treatment, which in their judgment may be deemed necessary in the care of my child.


CHILD’S ALLERGIES (if any) _________________________________________________________
CHILD’S DR. & PHONE # ____________________ FAMILY DR. & PHONE # ___________________
LAST TETANUS SHOT: _________ MEDICINE (S) CHILD IS TAKING _________________________
MEDICAL HISTORY (e.g. DIABETES, HEART DISEASE, etc.) _______________________________
INSURANCE COMPANY ___________________________ ID/POLICY # ______________________
SUBSCRIBER __________________________ SUBSCRIBER’S PHONE # ____________________
SUBSCRIBER’S PLACE OF EMPLOYMENT _____________________________________________

*(IF THERE’S A CHANGE IN COVERAGE OR STATUS, I/WE WILL NOTIFY FCABR ASAP)


SIGNATURE (PARENT/GUARDIAN) ____________________________________ DATE _________
PART 4 – PARENT/GUARDIAN WAIVER
I/We, the parents/guardians of this registrant, a candidate for FCABR and/or BRCTL baseball, hereby give our approval for his/her participation in any and all team activities. I/We certify that the registrant is in good health and that there is no physical or emotional reason that he/she cannot participate in the program.
I/We realize that baseball is a sport that may result in injury to a player. I/We assume all risks inherent in, and accidental to, the registrant’s participation in the program. Further, I/we hereby release, absolve, indemnify, and hold harmless the FCABR and/or BRCTL officers, organizers, coaches, participants and any baseball field on which the program plays or practices for any claim arising out of any injury to said player. I/We likewise waive, to the extent not covered by liability insurance, claims against any person transporting the registrant to or from Babe Ruth activities.
SIGNATURE (PARENT/GUARDIAN) ____________________________________ DATE _________
Please return pages 2 & 3 of this form, along with the appropriate registration fee to:

Lucy Wagner, 7426 Allan Ave., Falls Church, 22046

Please make checks payable to: FCABR

3.


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