Coach and Volunteer Registration - Fall 2017
Coach, Assistant Coach, Volunteer Registration
League Permission, Waiver and Release
Buddy Baseball Inc.
P.O. Box 290361
Temple Terrace, FL 33687-0361
www.buddybaseball.org - email: Russ@buddybaseball.org
If you want to be a "Buddy" and are between 10 and 22- this is the wrong registration form. You need the Buddy Registration form.
First Name for Uniform (Coaches, Assistant Coaches and Dug Out Helpers only)
Uniform Number - (Coaches and Assistant Coaches only)
Adult Extra Large
Adult 2 Extra Large
Adult 3 Extra Large
Including this season, how many seasons have you participated in Buddy Baseball?
6 - 10
Address Line 2
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
British Indian Ocean Territory
Central African Republic
Democratic Republic of the Congo
Republic of the Congo
Papua New Guinea
Saint Kitts and Nevis
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
United Arab Emirates
United States Minor Outlying Islands
Virgin Islands, British
Virgin Islands, U.S.
Cell Phone Number
Home Phone Number
I would like to volunteer as:
Check all that apply:
Meet and Greet
End of Season Party
If applicable, I would like to coach with:
I am a new coach or volunteer
Social Security Number for our Coaches/Assistant Coaches and Dug Out Helpers for background check. This will only be seen by the administrator and not be made public.
I am able to attend the Buddy Training and Coaches Meeting on Saturday 9/23/2017. Time - 12:00 to 1:00.
New Coach Training - Saturday 9/23/2017
Meet and Greet - Saturday 9/23/2017
Season - Saturdays 9/30/2017 - 11/11/2017
Buddy Baseball Bash (end of season party) - Sunday 11/12/2017
I am not available on these dates:
I am able to make the coaches meeting from 12:40 to 1:00 the day of the Meet and Greet. Saturday 9/23/2017
Something I would like you to know about me:
I would like to make a donation to the league
Not at this time
After you submit the registration, you will be directed to our payment page.
I would like to sponsor a Buddy Baseball team.
Not at this time
Single - $250
Double - $500
Triple - $750
Home Run - $1000
Grand Slam - $2500
How did you hear about Buddy Baseball?
I am a Returning Coach
At a community event
Local Recreation Center
4th of July Parade
FIT TO PARTICIPATE: I certify that PARTICIPANT is in good health and of sound body that warrants full participation in the Program and as outlined by the City of Temple Terrace Leisure Services Department Parks and Recreation Division. I certify that PARTICIPANT has had no known recent exposure to a contagious disease, and has no serious illness or injury which would restrict their participation in the Program. (PARTICIPANTS are encouraged to notify Program Supervisor in writing, of their known medical conditions or current medications, in the event that professional emergency care is required.)
PERMISSION TO PARTICIPATE: I accept full responsibility for PARTICIPANT to engage in the elected Program(s) as offered by the Parks and Recreation Division. I understand the nature of the Program, its activities, the dates and hours the Program operates, and fees. I understand that the structure of the Program does not allows minor child PARTICIPANTS to enter or leave the Program site unless accompanied by their parent, guardian or other authorized person listed above, unless a signed note from parent or legal guardian authorizing other permission is presented to staff and is verified.
All Volunteers, including but not limited to Buddys and Coaches, shall not participate in any BuddyBaseball event while under the influence of any substance, including but not limited to, alcoholic beverages, narcotic or any other medication or drug, which could possibly impair the Volunteer in any manner. If Volunteer is on a prescribed medication which could potentially impair the Volunteer in any manner, the Volunteer must disclose such information in Volunteer's application to BuddyBaseball or if such medication is prescribed after the application process, upon receipt of the medication. Failure to comply with this requirement will subject the Volunteer to immediate dismissal and exclusion from BuddyBaseball events.
WAIVER OF LIABILITY: In consideration of the covenants herein contained, I acknowledge that the elected Program or activity may involve physical exertion and contact which may result in injury. I assume all risks incidental to such participation including any risk or hazard in transportation to and from activities and/or school. I hereby waive, release, absolve, and hold harmless the City of Temple Terrace, Buddy Baseball Inc., its employees and elected officials, activity organizers, sponsors, participants and volunteers, for any loss, damage or injury of any nature whatsoever to person or property, and from any claims which arise from participating in any activity associated directly or indirectly with the Program. I further agree that any medical costs resulting from any such injury will be borne by the undersigned.
PHOTOGRAPH, VIDEOTAPE RELEASE: I agree that the Parks and Recreation Division and Buddy Baseball Inc. may take photographs or video of PARTICIPANT during Program activities, and that the Parks and Recreation Division and Buddy Baseball Inc. may release PARTICIPANT’S name along with their picture for publication in newspapers, program brochures, fliers, social media, etc.. I also agree that the Parks and Recreation Division and Buddy Baseball Inc. may use video tape of PARTICIPANT for public relations presentations.
Digital Signature of PARTICIPANT
Thanks for completing the registration.
We will be back in touch in mid September with your team information.
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Do Not Fill This Out