FERGUSON CHURCH OF THE NAZARENE
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2016 Baseball Registration
*
Indicates required field
Childs Name
*
First
Last
Gender
*
Male
Female
Age
*
Email
*
Primary Phone Number
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Secondary Phone Number
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Players Experience
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Home Church
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Special Health Needs
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I can not practice on (1 night a week, we do not practice on Wednesday nights)
*
Monday
Tuesday
Thursday
Friday
I would be willing to help with...
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Coaching
Assistant Coaching
Siblings in the League
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T-Shirt Size
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Yth Small
Yth Medium
Yth Large
Adlt Small
Adlt Medium
Adlt Large
Adlt XLarge
Pant Size
*
Yth Small
Yth Medium
Yth Large
Yth XLarge
Adlt Small
Adlt Medium
Adlt Large
Adlt XLarge
Emergency Name and Contact Number
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I hereby certify that my child is capable of safe participation in this children’s sport. I assume all risk(s) and hazards incidental to the play of this sport. I hereby authorize Ferguson Chil-dren’s program to obtain medical treatment for my child in the event that parents and emer-gency contact can not be reached.
Parent Signature
*
Pictures of my child taken during the events may be publicized
*
Yes
No
Submit
Home
About us
Exalt & Enjoy God
Equip Others
Engage The World
Giving
Contact
Ferguson Church Secure Site