Kiwanis Youth Baseball

Registration

Fall Registration

Cut-off date is September 1. That means that your child’s age on August 31 determines their ‘baseball’ age for the year.

The PREP league plays twice a week, games can be played Monday – Thursday. The JUNIOR league plays twice a week primarily on Tuesday, Wednesday, or Thursday. The SENIOR league plays twice a week, primarily on Tuesday and Wednesday. All leagues could have make-up games scheduled on any day including weekends.

A PLAYER MAY PARTICIPATE IN A ‘TRAVEL TEAM’ AND PLAY IN THE KIWANIS LEAGUE.

The cost of the summer program is $125.00 and the cost of the fall program is $110.00.

Consent-Registration 2022(WP)

Player Information
Player Name*
First Last
Date of Birth*
MM slash DD slash YYYY
Home Address*
Street Address Address Line 2 City State ZIP Code
School Presently Attending*
Grade Level*
Program Selection*
Previous Baseball Experience
Previous Baseball Experience
Year Played Name of the Organization(s) Primary Position(s) Played
Parent Information
Father's Name*
First Last
Father's Phone*
Father's Email*
Father's Address*
Same as Player's Home Address

Street Address Address Line 2 City State ZIP Code
Mother's Name*
First Last
Mother's Phone*
Mother's Email*
Mother's Address*
Same as Player's Home Address

Street Address Address Line 2 City State ZIP Code
Emergency Information
Family Physician*
Physician Phone*
Agreement*
I agree to the following:
In case of an accident or illness, I hereby authorize a representative of Western Kiwanis baseball to use his/her judgment in obtaining immediate Medical Care. (Parents will be notified in case of serious illness or injury as quickly as they can be reached, but this form will make immediate treatment possible.) I understand that if an accident occurs, I will not hold the staff, volunteers, or Kiwanis Club of Western Kenosha liable. I will take full responsibility for any medical needs my child may have due to an accident in the program.

I acknowledge my responsibility to report to my coaches, parent(s)/guardian(s) any signs or symptoms of a concussion and agree to abide by all Kiwanis Club of Western Kenosha concussion protocols.

I accept the Western Kiwanis Indemnity Clause and Parent Code of Conduct.
COVID-19 Waiver*
I agree to the following:
In consideration of being allowed to participate in any way in the Kiwanis Club of Western Kenosha program and related events and activities, the undersigned acknowledges, appreciates, and agrees that:

1. The risk of injury and/or illness from the activities involved in the program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist;

2. The risk to have direct or indirect contact with individuals who have been exposed to and/or diagnosed with one or more communicable diseases, including but not limited to COVID-19 or other medical conditions, diseases, or maladies, and/or any mutation or variation thereof does exist and it is impossible to eliminate the risk that I could become infected through contact with or close proximity to an individual with a communicable disease;

3. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my child’s participation;

4. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual, significant hazard during my presence or participation, I will remove myself from participation and bring such hazard to the attention of the nearest official immediately;

5. I, the parent/guardian, assert that I have explained to my child/ward: the risks of the activity, his/her responsibilities for adhering to the rules and regulations, and that my child/ward understands this agreement; and

6. I, for myself, my spouse and my child, and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS THE KIWANIS CLUB OF WESTERN KENOSHA its officers, officials, agents and/or employees, other participants, directors, sponsors, advertisers, and, if applicable, owners and lessors of the premises used to conduct an event (collectively, the "Releasees"), WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, VIRUS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.

This is to certify that I, as parent/legal guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns and next of kin, I release and agree to indemnify the Releasees from any and all liabilities incident to myself, my spouse and my minor child's involvement or participation in this program as provided above, EVEN IF ARISING FROM THEIR NEGLIGENCE.

I FOR MYSELF, MY SPOUSE AND MY CHILD HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Download Waiver
Signatures
Athlete Name*
Athlete Signature*
Parent/Guardian Name*
Parent/Guardian Signature*
Optional Information
Provide your name if you are interested in being a coach or a manager
First Last
Payment
Total
$0.00
Credit Card*
Card Details
Cardholder Name
Billing Address*
Same as Player's Home Address

Street Address Address Line 2 City State ZIP Code
Billing Email*

The email address where you'd like to receive your receipt
Comments
This field is for validation purposes and should be left unchanged.

Year Played	Name of the Organization(s)	Primary Position(s) Played

Kiwanis Youth Baseball

Registration

Fall Registration

Player Information

Previous Baseball Experience

Parent Information

Emergency Information

Signatures

Optional Information

Payment