SAMBA-2015-Registration-Form - Salmon Arm Minor Baseball

SALMON ARM MINOR BASEBALL ASSOCIATION REGISTRATION Registration deadline is Wednesday April 1, 2015 Parent Participation: Like most sport organizations, SAMBA relies on volunteers. SAMBA still needs a registrar for the 2015 season. Also needed each year is coaching staff. Effective 2015 season, SAMBA will be initiating a “Parent Participation deposit” because many of the jobs are done by the same few parents. This deposit can be post dated to June 27, 2015, once your coach has signed the participation form, your cheque will be returned. Participating can be in the form of, holding a board position, coaching, assistant coaching, score keeping, pitch counting, field prep, mowing lawns, weeding, team parent, division manager, fundraiser organizer for a division. The parent participation deposit is $35.00 UNIFORMS: are an important part of the game, it helps the players fell like a team and shows SAMBA is part of our community. These uniforms are a cost to SAMBA and over the years they have been depleted because they are not getting returned. This has forced SAMBA to ask for a uniform deposit, just like the parent participation deposit, the cheque can be post dated to June 27, 2015 and will be returned to you when the uniform is returned. The uniform deposit for Tadpole’s is $25.00 and for all higher levels is $40.00, (blast ball will not require a deposit). SEASON OPENING and CLOSING: SAMBA will be having an opening ceremony once again this year, photos will be taken during this time. SAMBA will also be hosting an association wide closing ceremony at the end of June. DIVISION DESIGNATION: are determined by birth year. A request for underage player movement to a higher birth age division needs to be in writing. Movement then required approval from SAMBA after the assessment day. (Movement can only take place if the higher levels have openings). Then SAMBA seeks approval from the BC Minor Baseball Association (BCMBA). PLAYERS: provide their own gloves, cleats and socks. It is also mandatory for athletes to wear an athletic supporter. PAYMENT & DEPOSITS: must be included with your registration form. Cheques can be made out to “SAMBA”. The registrant pays the penalty for a Non-­‐sufficient Funds (NSF) cheque. Financial support at PHOTOS: All players receive a team photo as a part of their registration fee. (to be taken at opening ceremony) THE SPRING SEASON: runs from mid April to late June. Typical days of participation are on the registration form and on the website. NOTE: Pee Wee, Bantam and Midget teams play interior interlock, which means games or practices happen during the week with at least one double header on a weekend day. COACHING & CLINICS: All coaches are encouraged to take the National Coaching Certification Program (NCCP) on-­‐
line Initiation Coach. SAMBA pays for this course and it takes very little time (1.5hr) Coaches then have on-­‐line access to numerous drills, etc. for a year. SAMBA will cover costs for other NCCP clinics as well. This April (exact date to be determined) Salmon Arm will be hosting a coaching clinic, so getting your coaching certificate could not be any easier. AS of 2011, coaches now need to submit Criminal Records check. Forms will be provided by SAMBA. CONTACT: Coaches will contact Spring League players by mid-­‐April. For younger age categories, there will be an assessment day to create balanced teams. If you have registered and have not heard from a coach by the middle of April, please check the website for information or call Shirley Deglan at 250-­‐832-­‐4513 or by email to [email protected] UMPIRING: If you and/or your child (born 2002 or before) is interested in paid umpiring, please indicate so on the registration form. Interested persons need to attend a mandatory Umpire Clinic. Contact the Umpire-­‐in-­‐chief -­‐ Dan Hiemstra at 250-­‐832-­‐6414 or email to [email protected] Salmon Arm Minor Baseball Registration Form One form per player. Deadline April 1, 2015 Medical form must be completed and included with this registration (one per player) REGISTRATION CAN BE DROPPED OFF AT: ASKEW’S UPTOWN (Customer Service Desk) or mailed to: SAMBA c/o BAG 9000 Ste 132 – 190 TCH NE, Salmon Arm, BC V1E 1S3 SECTION 1: PLAYER INFORMATION – PLEASE PRINT CLEARLY Name: Address: Birth date: mm_______dd________yyyy__________ Sex: M F (circle) City: Postal Code: BC Care Card# Father: Mother: Phone (Home) Phone (Home) Phone (Work/cell) Phone (Work/cell) Email: Email SECTION 2: SPRING LEAGUE REGISTRATION: MAKE CHEQUES PAYABLE TO “SAMBA” X Division by Cost Mar 1/15 (new rates) $35 Uniform Deposit (separate Ck) No deposit NIGHTS LOCATION Blast Ball U6/U7 (08/09) Cost before Feb 28/15 (2014 rates) $25 Weds (see Note below) Elk Park Tadpole U9 (06/07) $80 $95 $25.00 Tues and Thurs (see Note below) Elk Park Mosquito U11 (04/05) $90 $110 $40.00 BIRTH YEAR Mon and Wed (possible Elk Park tournaments as well) $100 $125 $40.00 Tues and Thurs (possible Klahani Park Peewee U13 (02/03) tournaments as well) $110 $140 $40.00 Mon and Wed plus possible one Blackburn Park Bantam U15 (00/01) double header on a weekend $110 $140 $40.00 Tues and Thurs plus possible one Blackburn Park Midget U18 (97/98/99) double header on a weekend NOTE: A parent/guardian must be in attendance with Blast ball and Tadpole players NOTE: Peewee, Bantam and Midget are interlocked with the interior so travelling will be involved. Parental Participation deposit: To encourage parents to participate and help grow SAMBA in Salmon Arm we are asking for a $35.00 refundable deposit. Your deposit will be refunded once your coach has signed off that you have participated in your division. _____ Cheque payable to “SAMBA” Family registration for Spring League: Registering 3 or more to a max of $250.00 _____ Uniform Deposit (Separate post dated Cheque) _____ Parent Participation Deposit (Separate post dated Cheque) _____ Cash or money order Refunds: No refunds for any reason other than medical after April 30, 2015. _____ Funding applied for Maximum refund after April 30, 2015 will be at 75% of fee. SECTION 3: VOLUNTEERING & UMPIRING: see description of duties on website. Division Manager Coaching Assistant Coaching Team Parent/Manager Umpire (paid position) Sponsorship Coaching Development Web Site Manager (board position) Field Maintenance helper Section 4: CONSENT I give my consent for the publication of my child’s name, photograph and comments for SAMBA newsletter, website and./or news media. I hearby waive and release any and all rights and claims that have or may arise against Salmon Arm Minor Baseball Association (SAMBA), its affiliates, associates, agents or representative, for any and all injuries or losses suffered by me or my children while competing in or in connection with the program of said Association. Also assume responsibility if a coach secures medical assistance where speed is urgent or when parent and/or guardians cannot be contacted. I hereby certify all above information is correct and consent for my child to take par in the SAMBA program. _______________________________________________________ _________________________________________________________________________ ____________________________________ Parent/Guardian (PRINT) Parent/Guardian (Signature) Date PLAYER’S MEDICAL HISTORY (to be completed by parent/guardian) NOTE: Forms are kept sealed in an envelope unless required. When the season ends, forms are shredded. IF THE MEDICAL CONDITION SHOULD BE MADE CLEAR – PLEASE TALK TO YOUR COACH DIRECTLY AS WELL. Division (X one): Blastball___ Tadpole____ Mosquito _______ Peewee ______ Bantam _______ Midget ________ Player’s name: _______________________________________________________ Birth date: D____________M____________Y____________ SEX __________________ Address:_____________________________________________________________________________________________________________________________________________ Family Physician: ________________________________________________________ Phone: _________________________________________________________________ BC Care Card#:___________________________________________________________ Parent/Guardian/Emergency Contact (in order of preferred contact): 1. Name:___________________________________________________________________ Relationship:_____________________________________________________ Home phone:_________________________________________Work:_______________________________________Cell:__________________________________________ 2. Name _______________________________________________________________________ Relationship:____________________________________________________ Home phone:_________________________________________Work:_______________________________________Cell:______________________________________________ Does your child suffer from (Y/N) Asthma_____________ Diabetes ____________________ Heart Disease ____________________ Headaches_________________________ Seizures________________ Other (Describe) _________________________________________________________________________________________________________________________________________ List any major injuries in the last 5 years: 1:________________________________________________________________________________________________________________________________________________________ 2:________________________________________________________________________________________________________________________________________________________ 3:________________________________________________________________________________________________________________________________________________________ Allergies:__________________________________________________________________________________ Has Epi-­‐pen_______________________________________________ Medications currently taking:________________________________________________________________________________________________________________________ Date Completed:______________________________________ Parent/Guardian signature:________________________________________________________________