Registration

Registration Type

Choose Game Type

Billing Information

Person that is paying the registration
First Name
Last Name
Address
City
State
Zip
Country
E-mail

Child Information

First Name
Last Name
Child's age as of May 1st 2012
School
Have you played before

Father Information

First Name
Last Name
Telephone
Email Address

Mother Information

First Name
Last Name
Telephone
Email Address

General Information

Coach Preference
Friend Preference
Do you want to be a coach?
Do you want to be a team mom?
Do you want a yard sign? $20
Do you want a window decal? $10

Waiver and Emergency Information

I/we am / are the parent, guardian, or custodial person of the above child, in consideration the he/she may play flag football or baseball with the Farm league. In the event that my/our child should become injured while he/she is engaged in football or baseball activities, I assume all risks and hazards incidental to such participation including transportation to and from the activities and do herby waive, release, absolve, and agree to hold harmless the Farm League, its officers, directors, managers, coaches, trainers, assistant directors, game officials, sponsors, supervisors, Spring/Klein/Tomball/ Cyfair schools, attending physicians, and any person transporting youth to and from any Farm league activity for any claim arising out of injury or for the administration or failure to administer first aid and or medical attention.

Secondly should my child become injured and I/we are not present and cannot be immediately contacted I/we herby appoint as legal guardian the Farm league for the limited purpose of defining, determining the necessity of and authorizing such medical attention or treatment as they deem appropriate. I/we herby release said officials from any and all liability, claim, or cause of action arising out of the good faith exercise of the power granted by this authorization.

Please provide the following medical information. In the event that your child should require treatment in your absence. The Farm League will attempt to obtain medical treatment from the doctor or facility you designate, if in their judgment, circumstances allow them to do so.
Child's Doctors Name
Doctor's Phone Number
Preferred Medical Facility
Address of Medical Facility
Insurance Carrier
Emergency Phone Number 1
Emergency Phone Number 2
I agree to all the following terms and conditions
Parents: On the next page you will be required to pay with your credit card. Your child will not be placed on a team if you do not make your payment online.

THE FARM LEAGUE
8765 Spring Cypress # L 161
Spring , Texas 77379
713 299 3005
All registrations final

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May 11, 2011
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