Anthracite Little League Association

Subscribe to our Newsletter

Anthracite JOC Registration Form

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Phone:

Birthdate:

Email:

Gender:

Grade:

PARENT/GUARDIAN #1

Firstname:

Lastname:

EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

WAIVER INFORMATION

Terms and Conditions:
1. I/We, the parents/guardians of the above-named candidate for a position on a Little League team,
hereby give my/our approval to participate in any and all Little League activities, including transportation to and from the activities.
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
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
claim arising out of any injury to my/our child whether the result of negligence or for any other cause.
3. I/We agree to return upon request the uniform and other equipment issued to my/our child in as good
conditions as when received except for normal wear and tear.
6. I/We agree to provide proof of legal residence (as defined by Little League Baseball,
Incorporated) and age. I/We understand that our child (candidate) must be eligible under the
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
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
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
forfeit(s) and/or suspension of Tournament privileges may be decreed by action of the
Charter Committee or Tournament Committee.
4. I/We agree that our child (candidate) may be required to try out for a team. If such does not attend at
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.
7. I/We will furnish a certified birth certificate of the above-named candidate to League
Officials.

Anti-Bulling Policy
The Anthracite Little League has adopted an anti-bullying policy. This policy overview is intended to guide all Managers, Coaches, Players, Volunteers, Parents, Guardians and Spectators in their behavior at Anthracite Little League games, events, and fields.

Bullying: Bullying involves behavior by one person or a group of people with the intent to ridicule, harass, humiliate or intimidate another person during league game, event and/or at league fields.

Verbal Bullying involves REPETITIOUS Behavior and includes the use of words and gestures.

Physical Bullying can include a SINGLE incident of pushing, hitting or kicking a person or interfering with their property.

Bullying which occurs outside of the little league setting may be addressed by the little league officials ONLY if such conduct markedly interrupts or severely impedes the purposes of Anthracite Little League.

Reporting Bullying: If you are being bullied, or know of someone being bullied, YOU must tell a team manager, coach or the president of Anthracite Little League, as soon as possible.

Consequences of Bullying:
If a person involved in the league (including managers, coaches, players, volunteers, guardians, and spectators) has taken part in bullying behavior, a warning will be given to that individual.
If the behavior continues, that person may be suspended or excluded from the fields for at least (1) full game. Any further incidents will be referred to the Board of Directors for further action which can include a further warning, discussions with parents/guardians, further suspensions or exclusions, ineligibility for playoff tournaments and/or all-star involvement, up to permanent removal from the league, and reporting to local law enforcement.

Fundraising:

? I agree to participate in Anthracite Little League Fundraising by either selling Lotto Calendars or Anthracite bracelets. I will sell either the following:
For 1 Child Participating in Anthracite Little League ? 10 Lotto Calendars
For 2 Children Participating in Anthracite Little League ? 15 Lotto Calendars
For 3 Children or More Participating in Anthracite Little League ? 20 Lotto Calendars

? I agree to opt-out of the Anthracite Little League Fundraising and Agree to the buy-out policy of $40 (1 child); $60 (2 children) $80 (three or more children).

Signature: ___________________________________________________________________ Date: ____________

I/we agree with the above *

test

* indicates required fields

OUR SERVICES

LOCAL SPORTS

ELITE

Anthracite JOC Registration Form