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Home Youth Sports Registration Form

Youth Sports Registration Form

Which program are you registering for? *

Child's Full Legal Name *

First

Middle

Last

Child's Date of Birth *

Child's Gender *

Child's Shirt Size *

Youth Small
Youth Medium
Youth Large
Youth X Large
Adult Small
Adult Medium
Adult Large
Adult X Large
Adult XX Large

Address

Address Line 1

Address Line 2

City

State

Zip Code

Parent/Guardian's Full Legal Name *

First

Middle

Last

Parent/Guardian Phone Number *

Can you receive text messages?

Yes
No

Parent/Guardian Email Address

I understand the cost to participate in youth basketball is $40 per participant. I understand payment can be made via cash, check (payable to City of Bessemer City), or by credit/debit card at the Allan Farris Community Center. *

Agree

Hold Harmless Agreement- I/We, the parents of the above named applicant, do hereby give my/our approval to his/her participation in any and all of the activities sponsored by the City of Bessemer City Parks & Recreation Department as long as he/she may be eligible to participate under the rules of the league. I/We agree that he/she may assume the risks and hazards incidental to such activities including transportation to and from such activities. I/We do hereby in consideration of his/her acceptance as a member of and being permitted to participate in league activities, waive, release, absolve and agree to hold harmless the City of Bessemer City and the organizers, sponsors and supervisors from any claims arising out of any injury to my son/daughter except to the extent and in the amount covered by accident or liability insurance carried at the time of accident for his/her benefit. We also understand that promoting sportsmanship is of the utmost importance. I/We also understand that if the rules on sportsmanship are abused by my son/daughter or my family that those person(s) will be subject to temporary or permanent suspension from participation in or attending games of the Bessemer City Parks & Recreation Department. I/We will also make the Bessemer City Parks & Recreation Department aware of any physical conditions that my child may have that the Bessemer City Parks & Recreation Department should be aware of at the time of registration. I also hereby give permission to City of Bessemer City Parks & Recreation to use any photography taken of my child as a participant or spectator for any promotional materials of publications without any compensation or other form of consideration. *

Agree

I understand that in order for my child to particpant in sporting programs, additional release forms may be required to complete depending on the recreation program. I also understand that I must sign a form in person during the first day of the recreation event. I also understand that all fees associated with the recreation program I am signing my child up for must be paid prior to participating in the recreation event. I understand I will be contacted for payment arrangements and options. *

Agree

I grant permission to allow my child’s name, photo, video recording and/or other items to be used at the discretion of Bessemer City Parks & Recreation in the promotion of its programs and activities. This information is no longer considered a Public Record in the State of North Carolina. *

Agree

Parents’/Legal Guardian Code of Conduct- I hereby pledge to provide positive support, care, and encouragement for my child participating in youth sports by following this Code of Conduct.  I will encourage good sportsmanship through my actions, by demonstrating positive support for all players, coaches, and officials at every practice, game or other youth sports event.  I will place the emotional and physical well being of the children ahead of any personal desire to win.  I will remember that my child is playing recreational sports for his/her enjoyment, not mine.  I will support the volunteer coaches and game officials that are working with my child, in order to encourage a positive and enjoyable experience for all.  I will remember that all Bessemer City Parks & Recreation coaches are volunteers. They have graciously given of their time for the development of my child, the program, and the sport.  I will help the coaches and my child by striving to make sure that they are on time, picked up promptly, and are properly equipped for all practice and games.  I will bring problems to the attention of the coaches in private after practices or games. Arguing with the coaches in front of the players or other spectators is detrimental to getting a successful resolution. If problems with coaches cannot be resolved. I will speak to the appropriate Bessemer City Park & Recreation personnel about the problem.  My child and I will treat other participants, coaches, officials, parents, and spectators with dignity and respect regardless of race, sex, creed, or ability.  I will show my appreciation for a good play, no matter who makes it, remembering that children learn best by example.  I will remember that parents should be cheerleaders. I will allow the coach to coach, the officials to officiate, and most of all the children to play the game.  I will respect the property and equipment used at any Bessemer City Parks & Recreation facility. I understand that as a parent of a child in a youth sports program provided by the Bessemer City Parks & Recreation Department, I must abide by this Code of Conduct. I have read, understand and agree to abide by all of the above conduct policies. I further agree that failure to abide by this Code of Conduct may result in temporary or permanent suspension from attending Bessemer City Parks & Recreation sponsored events. *

Agree

Parent Authorization (Type Name) *

Comment

Comments are closed.

City Hall: 132 W. Virginia Ave.
City Hall Annex: 125 E. Virginia Ave.
Bessemer City, NC 28016
704-629-5542

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