Columbus, MS

List Health or Medical Conditions the Coach Should Know About This Player

Emergency Contact (Other Than Guardian)

Phone*

Player's Shirt Size*

Youth Small (6 to 8)
Youth Medium (10 to 12)
Youth Large (14 to 16)

Adult Small
Adult Medium
Adult Large

Adult X-Large
Adult XX-Large
Adult XXX-Large

Name of Last Year's Team

I would like to volunteer as:

Agreement

Parents, Please Read the Following Statements Carefully!!!
I, the parent or guardian of the above-named candidate, participant, or registrant for a Columbus Recreation Department (CRD) team, program, camp or activity hereby give my approval to participate in any and all programs, practices, camps or activities during the season. I assume all risk and hazards incidental to such participation including transportation to and from activities; and I do hereby waive, release, absolve, indemnify and agree to hold harmless the Board of Directors, the staff and employees directors, organizers, sponsors, supervisors, participants, and persons transporting my child to or from activities, for any claim arising out of an injury to my child. Insurance coverage is the sole responsibility of parents or guardian.

A. The CRD does not carry any type of insurance for participants.

B. My child has my permission to receive emergency medical treatment.

C. My child may be photographed during any CRD activities.

D. Once the player drafts and selections have been complete, I understand the only refund that may be considered would be 1/2 of the registration fee.

E. The CRD makes every possible effort to secure a coach for each league team before the player drafts occur, however, I understand that if this is not possible, that a member of the CRD staff will draft for that team.

Players are drafted onto teams and there is no guarantee a player will be placed on a certain team, with certain players or certain coaches.

Parents, Please Read the Following Statements Carefully!!! I, the parent or guardian of the above-named candidate, participant, or registrant for a Columbus Recreation Department (CRD) team, program, camp or activity hereby give my approval to participate in any and all programs, practices, camps or activities during the season. I assume all risk and hazards incidental to such participation including transportation to and from activities; and I do hereby waive, release, absolve, indemnify and agree to hold harmless the Board of Directors, the staff and employees directors, organizers, sponsors, supervisors, participants, and persons transporting my child to or from activities, for any claim arising out of an injury to my child. Insurance coverage is the sole responsibility of parents or guardian. A. The CRD does not carry any type of insurance for participants. B. My child has my permission to receive emergency medical treatment. C. My child may be photographed during any CRD activities. D. Once the player drafts and selections have been complete, I understand the only refund that may be considered would be 1/2 of the registration fee. E. The CRD makes every possible effort to secure a coach for each league team before the player drafts occur, however, I understand that if this is not possible, that a member of the CRD staff will draft for that team. Players are drafted onto teams and there is no guarantee a player will be placed on a certain team, with certain players or certain coaches.

Electronic Signature: Important*

Checking this box constitutes an electronic signature. By checking this box, I affirm that the facts set forth in my registration are true and complete and agree entirely to the statement above.

I agree

By checking the box, I acknowledge the payment arrangement as stated:*

Before player registration can be fully accepted payment must be received by the Columbus Recreation Department. Online payment methods will be outlined after the player registration form is submitted. The cost for online registration is $30 FOR T-Ball, $40 for Coach Pitch, and $50.00 for Baseball/Softball.

Yes, I understand that registration is not valid without payment.

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