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For more information call
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or email
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BGCCB Sports League Registration Form
File Size:
338 kb
File Type:
pdf
Download File
Sports League Registration
Sports League Informa
tion
*
Indicates required field
Participating Sport
*
Choose One
Coed Tee-Ball (ages 4-6)
Coed Coach Pitch (ages 7-8)
Youth's Jersey/Shirt Size
*
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult 1X
Adult 2X
Youth Information
Youth's Name
*
First
Last
Youth's Gender
*
Male
Female
Do not disclose
Youth's Date of Birth (MM/DD/YYYY)
*
Youth's Age
*
Youth's School Name
*
Youth's School Grade
*
Primary Contact Information
Primary Contact's Name
*
First
Last
Primary Contact's Relationship to Youth
*
Mom
Dad
Step Mom
Step Dad
Grandparent
Aunt/Uncle
Foster Parent
Legal Guardian
Other
Primary Contact's Phone Number
*
Primary Contact's Email Address
*
Primary Contact's Physical Address
*
Line 1
Line 2
City
State
Zip Code
Country
Emergency Contact Information
Emergency Contact's Name (Other Than Primary Contact)
*
First
Last
Emergency Contact's Relationship to Youth
*
Mom
Dad
Step Mom
Step Dad
Grandparent
Aunt/Uncle
Foster Parent
Family Friend
Other
Emergency Contact's Phone Number
*
Emergency Contact's Email Address
*
Statistical Data
BGCCB is a 501(c)(3) non-profit organization. The following information is necessary for our records and the funding our organization receives. The answers you provide are kept completely confidential.
Youth's ethnicity
*
Hispanic, Latino
White, Caucasian
Black, African American
Asian
Native Hawaiian/Pacific Islander
American Indian/Alaska Native
Bi/Multi Racial
Does the youth participate in the school lunch program
*
Free Lunch
Reduced Lunch
Not Eligible
Does youth live in a single-parent household?
*
Yes
No
What is your annual household income
*
$0-$10,000
$10,001-$20,000
$20,001-$30,000
$30,001-$40,000
$40,001-$50,000
$50,001-$62,999
$63,000 and up
Known Health Concerns
Please list any health concerns BGCCB needs to be aware of during games & practices (i.e. asthma, heart conditions, etc.)
Known health concerns (N/A if not applicable)
*
How did you hear about us?
Choose all that apply
*
Family or Friend
Flyer or Phone
Email or Newsletter
Social Media or Website
TV Advertisment
Other
Acknowledgment
I approve of my child’s application for membership and/or participation in Boys & Girls Clubs of the Coastal Bend (BGCCB) sports leagues. I will not hold the members of the Board, staff or leaders responsible for injury, which may occur while participating in the BGCCB activity mentioned above. I understand that I am responsible for transporting my child to and from events. I also acknowledge that medical insurance is not provided through BGCCB.
PLEASE NOTE:
1.
Players who have unpaid balance from previous BGC leagues will not be allowed to play until payment is made in full.
2. Sports League f
ees are NON-REFUNDABLE due to equipment cost, uniforms, Referees, and administrative fees.
3. BGCCB has a NO REFUND policy.
Electronic Signature (Sport League Registration)
*
Date (MM/DD/YYYY)
*
PARTICIPANT RELEASE OF LIABILITY
Youth's Name
*
First
Last
In consideration of being allowed to participate in any way in the program, related events and activities, I the undersigned, acknowledge, appreciate, and agree that:
The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist and,
I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLI-GENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and,
I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately, and
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS THE Boys & Girls Clubs of the Coastal Bend, their officers, officials, agents and/or employees, 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, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.
GENERAL MEDIA & PHOTOGRAPHIC RELEASE
The Boys & Girls Clubs of the Coastal Bend as well as Boys & Girls Clubs of America frequently use photographs information from surveys, and quotes from the members to publicize programs. Your permission is needed to use photos, testimonies, and videos, including information from surveys and/or quotes of your child(ren) on our web site (www.bgccb.org) in informational brochures, social medina and in news articles. I give my consent for any photographs or reproductions thereof (while he/she is engaged in Club-related activities) and in which my child(ren) appear or quotes my child(ren) give to be used in anyway the Club may choose including grant/publicity/fundraising purposes
General Media & Photographic Release
*
Yes
No
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
FOR PARENTS/GUARDIANS OF PARTICIPANT OF MINOR AGE
(UNDER AGE 18 AT TIME OR REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releases, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releases from any and all liability incidents to my minor child's involvement or participation in these programs as provided above. EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES, to the fullest extent permitted by law.
The Boys & Girls Club of The Coastal Bend athletics programs provide boys and girls of all ages, regardless of their athletic ability, the opportunity to learn new skills and develop self-esteem, teamwork and leadership skills. Sports programs emphasize fun and full participation for every youth. Coaches and spectators are expected to demonstrate good sportsmanship and positive support for all players and officials.
Electronic Signature (Release of Liability)
*
Date (MM/DD/YYYY)
*
Tee Ball/Coach Pitch Rules & Regulations
Tee Ball Rules
Coed Ages 4-6
Players’ ages are four to six.
Players on a team – 9 minimum, 12 maximum
50 feet between the bases.
A real or imaginary playing line is between first base and third base or an arc 40 feet from home plate.
Every player bats and plays in the field.
The ball is hit off a batting tee; there is no pitching.
There are no walks or strikeouts.
No bunting will be allowed.
No catcher will be used.
Offense may have a batting coach and two base coaches on the field.
Defense may have two field coaches on the field to assist the players.
No umpire will be used for this division.
The ball must travel 10 feet or it is a foul.
No fielder may cross the playing line until the ball is hit.
No stealing. Player stays on the base until the ball is hit.
An inning is over when all the players have batted once.
Standard game is four innings.
Scores are not kept for the younger players.
Safety helmets must be worn.
Gloves must be worn while in the defensive fielding position.
Tee – adjustable, flexible tube on a moveable base.
Athletic footwear. No metal cleats.
There will be a $1 entrance fee for all spectators (players, coaches, volunteers exempt). All games played at BGCCB fields (3902 Greenwood Dr.)
Jerseys will be provided.
Unsportsmanlike conduct will NOT be tolerated. Players, parents and coaches may receive one warning.
A second offense will result in then removal from the game.
Anyone who is ejected from a game must also leave the park for the day and may be subject to further suspension.
We encourage coaches and players to shake the opponents’ and officials’ hands after each game to emphasize positive teamwork and sportsmanship.
Coach Pitch
Coed Ages 7-8
Teams are required to provide a coach or parent to act as umpire during the duration of the game.
Both teams will provide a coach or parent to underhand pitch for their respective team.
The coach may pitch from any distance he wants between the pitcher’s mound and within 15 ft. of home plate.
While the coach is pitching the defensive player will stand near the pitching mound to field the ball.
Coach-Pitcher may not field the ball and must avoid interfering with play once the ball is hit.
The team at bat may have a coach at first, third, and home plate.
The team in the field may have a maximum of two coaches on the field.
Players on team – 9 minimum, 12 maximum
The defense will consist of 10 players at a time: pitcher, catcher, 4 infielders, and 4 outfielders
No player will sit on the bench more than one inning when their team takes the defensive position.
Defensive positions will consist of a pitcher, catcher, first baseman, second baseman, third baseman, shortstop and no more than four outfielders.
Each outfielder must be positioned no closer than ten feet behind the bases.
The catcher must stay in catcher’s safety area until ball is hit.
Infielders may be no closer than 20 feet from home plate prior to the ball being hit
Pitcher must stand to the side or behind the pitching rubber until ball is hit
Defensive players must be located in standard positions with no extreme oversights.
There will be 3 outs per inning.
Score will be kept.
A batter that throws his bat in a hazardous manner will be called out.
Bunts are not allowed.
3 strikes is an out, 4 balls will result in a walk.
If a player is struggling to hit, it is up to the coach’s discretion if a tee is needed.
Base runners may lead off no more than 3 ft.
Base runners leaving the base path in order to avoid a tag will be declared out.
Base runners cannot steal bases. The runner will be declared out if caught stealing.
A runner who intentionally runs into a defensive player will declared out.
Sliding will be allowed.
Jerseys will be provided.
Each player must wear a baseball glove while in the defensive fielding position.
Athletic shoes or rubber cleats are allowed – NO METAL CLEATS
Catchers must wear full catchers gear (which will be provide)
Batting helmets must be worn by the batting team while on the field (warming up to hit, at the plate, and on the bases)
Each game will consist of 6 innings
The ball is declared dead when the pitcher has the ball in his/her possession and is standing on the pitching rubber.
Base runners must tag on all fly balls.
There will be a $1 entrance fee for all spectators (players, coaches, volunteers exempt). All games played at BGCCB fields (3902 Greenwood Dr.)
Unsportsmanlike conduct will NOT be tolerated. Players, parents and coaches may receive one warning.
A second offense will result in then removal from the game.
Anyone who is ejected from a game must also leave the park for the day and may be subject to further suspension.
We encourage coaches and players to shake the opponents’ and officials’ hands after each game to emphasize positive teamwork and sportsmanship.
HAVE FUN!
Athletics Code of Conduct
No coach, player or spectator may approach the referee or gym staff before, during, or after the game in an aggressive or abusive manner, verbally, or physically.
The first violation
will result in
a written warning and possible suspension from the next scheduled game.
The second violation
will result in
dismissal from his/her coaching/player duties.
If a player/coach is ejected from the game, he/she will be suspended for the next game and may be subject to further disciplinary action.
The player must serve his/her one (1) game suspension by
sitting
on the bench with teammates for the entire game.
In the event that a coach’s behavior contradicts the purpose of the league, (to teach basics of basketball as well as
exemplify a positive role model
) the coach will be dismissed from his/her coach’s duties.
No coach, player, or spectator shall:
Disrespectfully address or physically confront an official or Club Staff.
Attempt to influence an official’s decision
Use profanity
Disrespectfully address or bait an opponent, coach, player or Club staff
Object to an official’s decision by rising from the bench or using gestures
Incite undesirable crowd reactions
Yell at or mistreat a player, referee, another coach, parent or Club staff
Coaches will always wear their
Coach
shirt while coaching.
Electronic Signature (Tee Ball/Coach Pitch Rules & Regulations)
*
First
Last
Date (MM/DD/YYYY)
*
COVID-19 Release
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization
. COVID-19 is extremely contagious
and is believed to spread mainly from person-to-person contact. As a result, federal, state, and local governments and federal and state health agencies recommend social distancing and have, in many locations, prohibited the congregation of groups of people.
Boys & Girls Clubs of The Coastal Bend, Inc. (Club) has put in place preventative measures to reduce the spread of COVID-19; however, the Club
cannot guarantee
that you and/or your child(ren) will not become infected with COVID-19. Further,
attending the Club and/or participating in Club sports leagues could
increase
your risk and/or your child(ren)’s risk of contracting COVID-19.
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that my child(ren) and/or I may be exposed to or infected by COVID-19 by participating in any Club programs and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the Club may result from the actions, omissions, or negligence of myself and others, including, but not limited to, Club employees, volunteers, and program participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I and/or my child(ren) may experience or incur in connection with mine and/or my child(ren)’s attendance at the Club or participation in Club programming (“Claims”). On my behalf, and/or on behalf of my child(ren), I hereby release, covenant not to sue, discharge, and hold harmless the Club, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of the Club, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any Club program.
Youth's Name
*
First
Last
Electronic Signature (COVID-19 Release)
*
First
Last
Date (MM/DD/YYYY)
*
By pressing submit, you are stating that you have completed and acknowledged the following documents: Sports League Registration, Tee Ball/Coach Pitch Rules & Expectations, and COVID-19 Release.
Submit