2022 Decatur National Dixie Youth Baseball (3 Players)

* Required Fields
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Fee: $9.00Card Processing Fees
League Fees (registration discount with 3 siblings)
4 yr old: $50.00
5/6 yr old: $76.00
7/8 yr old: $88.00
9/10 yr old: $88.00
11/12 yr old: $88.00
League Age Birthday Ranges
4 yr        May 2017 - Dec 2018
5/6         May 2015 - April 2017
7/8         May 2013 - April 2015
9/10       May 2011 - April 2013
11/12     May 2009 - April 2011
1st Child Registration
*Child's First Name
*Child's Middle Name
*Child's Last Name
*Child's Date of Birth
*Age Division
*Jersey Size
*School Player Currently Attends
Age Group Child Played in Last Year
Team Child Played on Last Year
2nd Child Registration
*Child's First Name
*Child's Middle Name
*Child's Last Name
*Child's Date of Birth
*Age Division
*Jersey Size
*School Player Currently Attends
Age Group Child Played in Last Year
Team Child Played on Last Year
3rd Child Registration
*Child's First Name
*Child's Middle Name
*Child's Last Name
*Child's Date of Birth
*Age Division
*Jersey Size
*School Player Currently Attends
Age Group Child Played in Last Year
Team Child Played on Last Year
Parent/Legal Guardian 
*Name of Parent or Legal Guardian #1
*Relation to Child
Home Phone
*Cell Phone #1
*Email Address #1
*Address
*City
*State
*Zip Code
Name of Parent or Legal Guardian #2
Relation to Child
Cell Phone #2
Email Address #2
Address
City
State
Zip Code
*Emergency Contact
*Emergency Contact Phone #
The Registration Fees will include the cost of a Uniform Hat and Jersey.  Each Player will also be required to purchase their Uniform Pants, Socks, and Belt.  Fees supplement costs for Umpires and Scorekeepers.  Each Child will also be asked to participate in our Fundraiser which helps to cover costs that are not included in standard fees.
SCHOLARSHIP INFORMATION
 I would like to sponsor an additional child who may not have the ability to pay (include additional $110.00 with registration fee) (+$110.00)
VOLUNTEER
 I am willing to volunteer my time to help coach, be a team mom, help with fundraisers, or help with tournaments this year.

If you are willing to volunteer you must sign and return the background check authorization form and the Coaches Code of Conduct

You must also read our Abuse/Molestation Risk Management Program document.

Your background check must be complete before you are able to participate in on field events with your team. The background check cost of twenty dollars ($20) must be paid by the volunteer and it lasts three (3) years. 
*PARENT OR LEGAL GUARDIAN ACKNOWLEDGEMENT
 I certify that the above information is true and correct and I have read and understood the Code of Conduct Policy in the Decatur National Rule Book.

I have reviewed and read the Minor Waiver and release of liability for minor participants.

All of our volunteers submit to a background check and follow our Abuse / Molestation Risk Management Program.

We are also providing you with a Parent's Guide to Child Abuse. 
*PHOTO RELEASE
 I authorize Decatur National to use photos/videos, and/or other likenesses of myself and/or my child or the child for whom I have legal guardianship for any promotional materials regarding Decatur National programs, facilities, or services.

Such likenesses will not be sold to other parties. Promotional materials bearing these likenesses may be distributed for free to the public and posted on the Decatur National website and social media outlets. Decatur National reserves the right to use any photo/video or likeness for a time period beginning when this form is signed and ending upon written request of participant, parent or legal guardian. 
Release of Liability for Minor Participants
IN CONSIDERATION OF my child/ward's named above, being allowed to participate in any way in the Decatur National Dixie Youth Baseball related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1. The risk of injury to my child/ward from the activities involved in these programs is significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and,

2. I FOR MYSELF, SPOUSE, AND CHILD/WARD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child/ward’s participation; and,

3. I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child/ward’s readiness for participation and/or in the program itself, I will remove my child/ward from the participation and bring such attention to the nearest official immediately; and,

4. I for myself, my spouse, my child/ward, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Decatur National Dixie Youth, its directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event (“Releasees”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property incident to my child/ward’s involvement or participation in these programs, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

5. I, for myself, my spouse, my child’s/ward, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my child’s/ward involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
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*Type Signature of Waiver Acknowledgement
Total Due:
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