El Campo Little League P.O.

Box 586 El Campo, Texas 77437

Dear Little League Parent, It is time to organize for the 2011 season. Enclosed is the registration form for your child(ren). If your child(ren) was in the program last year, you may register by mail. The deadline for registration will be January 31, 2012. Please make any necessary changes on the enclosed form and sign it at the bottom of the page. The registration fee for 2011 will be $65.00 for all ages except Tee-Ball (5-6 year olds) Registration Fee for Tee-Ball will be $50.00. If the players parent/guardian fails to register their child(ren) by the deadline,

El Campo Little League can not guarantee the player will be placed on a team, however once a player is drafted on a team refunds will not be available.
Make your checks payable to: El Campo Little League P.O. Box 586 El Campo, Texas 77437

El Campo Little League will hold open registration at El Campo Little League Office. (204 N. Washington St., across from Novaks meet market) on Saturday, January 7th between 10:00am and 12:30pm. We will have a 2nd registration on Wednesday, January 11th between 6:00pm and 8:00pm at the same location.. Parents and other people need to volunteer in the program as Managers, Umpires, and Coaches. Please complete the Volunteers Application and turn it in with the completed player registration. Try outs for Pee Wee (7~8), American League (9~10), and National League (11~12) will be held at the ball park on Saturday, February 18 (See schedule below). Make up Tryouts will be on Monday February 20 starting at 6:00 pm (make up tryouts are for children who missed Saturdays tryout only) Try outs for Junior League and Girls Senior League will be Saturday March 31 only.

Your childs age is based on their age as of: Boys - April 30, 2012 Girls Dec. 31, 2011
(If the Tryouts are Rained out or Canceled there will be no Makeup. We will conduct a Blind Draft)
We will need parents that can help during the tryouts so all volunteers are welcome! Pee Wee (7~8), American (9-10), and National (11~12)

Softball Saturday Feb. 18

All tryouts on girls Senior Field #4 Girls 7-8 9:00 am Girls 9-10 10:00 am Girls 11-12 11:00 am All Make Ups will be on Monday February 21 on Field 6 beginning at 6:00 pm Junior League (13~14) Senior League (15~16)

Baseball Saturday Feb. 18

Pee wee Field 3 Age 7 9:00 am Pee wee Field 3 Age 8 10:30 am American Field 5 Age 9 9:00 am American Field 5 Age 10 10:30 am National Field 6 Age 11 9:00 am National Field 6 Age 12 10:30 am (only if new player)

Softball Saturday March 31

Baseball Saturday March 31

Senior Field 4 Boys Senior (High School Field) Girls Junior/Senior(13~16) on Field 4 10:00 am Boys (13~14) on Senior Field 7 10:00 am Boys Senior (15~16) will be done at a later date: (Still register and players will be notified) Thank you for your participation and your help is appreciated. El Campo Little League Board of Volunteers
If you have a question Call Chad Ellis at : (979) 358-0478 Email chad@ei-law.com UPDATED INFORMATION AND RAINOUT INFORMTION AVALIABLE AT www.eteamz.com/ec

TEAR OFF and READ!!!! Keep it posted as a reminder

Little League Baseball and Softball

M E D I C A L

R E L E A S E

NOTE: To be carried by any Regular Season or Tournament Team Manager together with team roster or eligibility affidavit. Player: _____________________________________ Date of Birth: ____________ Gender (M/F):_________________

Parent (s)/Guardian Name:_____________________________________ Relationship:____________________________ Parent (s)/Guardian Name:_____________________________________ Relationship:____________________________ Players Address:____________________________________ City:_______________ State/Country:________ Zip:______ Home Phone:_____________________ Work Phone:______________________ Mobile Phone:_____________________ PARENT OR GUARDIAN AUTHORIZATION: In case of emergency, if family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel. (i.e. EMT, First Responder, E.R. Physician) Family Physician: ____________________________________________ Phone: _________________________________ Address: __________________________________________ City:________________ State/Country:_________________ Hospital Preference: __________________________________________________________________________________ Parent Insurance Co:_________________________ Policy No.:__________________Group ID#:_____________________ League Insurance Co:_________________________ Policy No.:__________________League/Group ID#:______________ If parent(s)/guardian cannot be reached in case of emergency, contact: ___________________________________________________________________________________________________ Name Phone Relationship to Player ___________________________________________________________________________________________________ Name Phone Relationship to Player
Please list any allergies/medical problems, including those requiring maintenance medication. (i.e. Diabetic, Asthma, Seizure Disorder)

Medical Diagnosis

Medication

Dosage

Frequency of Dosage

Date of last Tetanus Toxoid Booster: ______________________________________________________________________

The purpose of the above listed information is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment.

Mr./Mrs./Ms. ________________________________________________________________________________________ Authorized Parent/Guardian Signature Date: FOR LEAGUE USE ONLY: League Name:_______________________________________________ League ID:________________________________ Division:_________________________________Team:______________________________ Date:____________________
WARNING: PROTECTIVE EQUIPMENT CANNOT PREVENT ALL INJURIES A PLAYER MIGHT RECEIVE WHILE PARTICIPATING IN BASEBALL/SOFTBALL.
Little League does not limit participation in its activities on the basis of disability, race, color, creed, national origin, gender, sexual preference or religious preference.

2012 El Campo Little League

Player Registration Form

Player name Address Address 2 City/State/Zip Home phone Email ( ) My child will tryout for: Birthdate Gender League Age/ Fee

Age

Amount

Baseball Softball

Parent #1 Name Phone Email Occupation Volunteer? ( )

Parent #2 Name Phone Email Occupation ( )

If checked, fill out "Volunteer Application"

Volunteer?

If checked, fill out "Volunteer Application"

Medical Information Emergency contact Relationship to player Insurance carrier Policy Phone

League Use Only

Birth Certificate Proof of Residency

Yes

No
No

Yes

No
No

Medical Release Form Waiver needed?

Yes

Yes

Level Assigned

Team Name

1. I/We, the parents/guardians of the above-named candidate for a position on a Little League team, 6. I/We agree to provide proof of legal residence (as defined by Little League Baseball, hereby give my/our approval to participate in any and all Little League activities, including transportation to Incorporated) and age. I/We understand that our child (candidate) must be eligible under the and from the activities. residence and age regulations of Little League Baseball, Incorporated, to participate in this Local League, and that if any controversy arises regarding residence and/or age, the 2. I/We know that participation in baseball or softball may result in serious injuries and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnify, and decision of the Charter Committee in Williamsport shall be final and binding. I/We further understand that if any participant on a Little League team does not qualify for participation in agree to hold harmless the local Little League, Little League Baseball, Incorporated, the organizers, sponsors, supervisors, participants, and persons transporting my/our child to and from activities from any the league based on residence (as defined by Little League Baseball, Incorporated) and/or age, such participant and/or team on which he/she participates be found ineligible, and claim arising out of any injury to my/our child whether the result of negligence or for any other cause. forfeit(s) and/or suspension of Tournament privileges may be decreed by action of the 3. I/We agree to return upon request the uniform and other equipment issued to my/our child in as good Charter Committee or Tournament Committee. conditions as when received except for normal wear and tear. 7. I/We will furnish a certified birth certificate of the above-named candidate to League 4. I/We agree that our child (candidate) may be required to try out for a team. If such does not attend at Officials. least 50 percent of the tryouts, local Board-of -Directors' approval is required for such candidate to be placed on a team. 5. I/We understand that our child (candidate) may be chosen at anytime to play on a Major Division team, if he or she is of the correct age for such division as determined by the local league and Little League Baseball. Declining to move up to such Major Division team will result in forfeiture of eligibility for the Major Division for the current season, and may be subject to further restrictions by the local league.

Signature

Date
Rev. 1/03

Do not use forms from past years. Use extra paper to complete if additional space is required.
A COPY OF VALID GOVERNMENT ISSUED PHOTO IDENTIFICATION MUST BE ATTACHED TO COMPLETE THIS APPLICATION. Name __________________________________ date ___________________ Address ________________________________________________________ City ____________________________ State _________Zip _____________ Cell Phone Business Phone e-mail Address: date of Birth ____________________________________________________ Occupation _____________________________________________________ Social Security # (mandatory upon request or with LexisNexis) ____________________ employer _______________________________________________________ Address ________________________________________________________ Special professional training, skills, hobbies: ___________________________ _______________________________________________________________ Community affiliations (Clubs, Service Organizations, etc.): _______________________________________________________________ Previous volunteer experience (including baseball/softball and year): _______________________________________________________________ do you have children in the program? Yes No if yes, list full name and what level? _____________________________________________________ Special Certification (CPR, Medical, etc.): ______________________________ do you have a valid drivers license: Yes No drivers License#: ________________________________State ___________ Have you ever been convicted of or plead guilty to any crime(s): Yes No if yes, describe each in full:_________________________________________ _______________________________________________________________ Are there any criminal charges pending against you regarding any crime(s) involving or against a minor? Yes No if yes, describe each in full:______________ __________________________________________________________________ Have you ever been refused participation in any other youth programs? Yes No if yes, explain: ___________________________________________________ _______________________________________________________________ in which of the following would you like to participate? (Check one or more.) League Official Coach umpire field Maintenance Manager Scorekeeper Concession Stand Other
Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program: Name/Phone ______________________________________________________________________ ______________________________________________________________________ AS A CONditiON Of vOLuNteeRiNg, i give permission for the Little League organization to conduct background check(s) on me now and as long as i continue to be active with the organization, which may include a review of sex offender registries, child abuse and criminal history records. i understand that, if appointed, my position is conditional upon the league receiving no inappropriate information on my background. i hereby release and agree to hold harmless from liability the local Little League, Little League Baseball, incorporated, the officers, employees and volunteers thereof, or any other person or organization that may provide such information. i also understand that, regardless of previous appointments, Little League is not obligated to appoint me to a volunteer position. if appointed, i understand that, prior to the expiration of my term, i am subject to suspension by the President and removal by the Board of directors for violation of Little League policies or principles. Applicant Signature _______________________________________ date _________ if Minor/Parent Signature___________________________________date __________ Applicant Name(please print or type) _______________________________________
NOTE: The local Little League and Little League Baseball, Incorporated will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or disability.

Little League Volunteer Application -2012

Background check completed by league officer ________________________________ on ____________________________________________________________________ System)s) used for background check (minimum of one must be checked): Sex Offender Registry Criminal History Records *LexisNexis

LocaL League use onLy:

*Please be advised that if you use LexisNexis and there is a name match in the few states where only name match searches can be performed you should notify volunteers that they will receive a letter directly from LexisNexis in compliance with the Fair Credit Reporting Act containing information regarding all the criminal records associated with the name, which may not necessarily be the league volunteer.

Only attach to this application copies of background check reports that reveal convictions of this application.
1-02-11-vOLuNteeR APPLiCAtiON 3/28/11