BUSSELTON TEE-BALL ASSOCIATION (Inc)

REGISTRATION FORM

Fees - Payment Details – For Office Use Only

Chq / Cash

Receipt No.

Amount Paid

Reg. No.

PLAYER DETAILS

Family Name: ……………………………….….….……. First Name: …………..……………..…….…

Address: ………………………………………………………………….…… Age(as at 31 December) …………….

Telephone: ………………………… Femaler Maler D.O.B. ………………….

Do you have access to the Internet? Yesr Nor

Current School: ………………………………………………….. Year Level at School: ……..………

Last Year’s Team: (if applicable) …………………………………………………

Past Tee-ball Experience: Noner 1 yearr 2 yearsr Morer

Preferences:(Please indicate any preferred team or friends you wish to play with. However, please note, the Committee allocates players to teams. Although requests for team placement will be taken into consideration, children are ultimately placed to ensure equable ability of the players in each team. An even competition is our Association’s objective.) …………………………………………………………………………………………………………………

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Special Needs:(Please indicate any condition that we should know about, eg allergies, asthma, etc.)

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Are you interested in trying out for South West Championships? Yesr

PARENT DETAILS

Parent Name(s): …………………………………………… Emergency Contact: …………………………

Parent(s) please note: Tee-ball is a family sport. Teams can only be fielded if the parents take an active interest and involvement. Please indicate below the areas in which you can assist.

Team Coachr	Assistant Coachr	Umpirer	Team Managerr	Ground Markerr	Scorerr
Committee Memberr	Are you a sponsor?r		Possess First Aid Certificater	Otherr	…………….

I am interested in sponsoring a team. Please contact me with more information.r

Busselton Tee Ball has a website (www.tbawa.org.au/busselton ). It is anticipated that action shots from Saturday games will be posted on the website on a weekly basis (no names will be included with photos). However, parent/guardian approval is required for your child’s picture to be posted. Please tick one of the boxes below.

I approver I do not approver of my child’s picture being posted on the Internet.

In consideration of my right to participate in the activities and facilities provided by the Busselton Tee-Ball Association (Inc) and its coaches, instructors and other employees or sub-contractors (“the club”), I have and do hereby assume all risks arising out of the use by my child of the facilities and services provided by the club and hereby release the club from and hold the club harmless from all liability, actions, debts, claims and demands of whatsoever nature which I now have or which may arise in connection with the use by my child of all or any of the club’s facilities or services.

Signature: (Parent/Guardian) ………………………………………………….. Date: …………………

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