Baseball Registration

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 *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Secondary Phone Number *

Players Experience *

Home Church *

Special Health Needs *

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... *

Coaching Assistant Coaching

Siblings in the League *

T-Shirt Size *

Pant Size *

Emergency Name and Contact Number *

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

Ferguson Church of the Nazarene.
1309 N. Elizabeth Ave.
Ferguson MO, 63135.
Phone: 314.522.3388

Home
About us
Exalt & Enjoy God
Equip Others
Engage The World
Giving
Contact
Ferguson Church Secure Site