Flames Registration – Rock River Please enable JavaScript in your browser to complete this form.Athlete Information – Step 1 of 6Name *FirstLastEmail *Phone *Address *Address Line 1Address Line 2CityWisconsinAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeEmergency Contact (In case of injury) *FirstLastPhoneNextPlayer InformationPlayers Date of Birth *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Player's gender *MaleFemaleSelect One *Rock River- 18 and OverRock River League is an adult baseball league for men 18 and over Baseball Shirt Size *SmallMediumLargeX Large2XRock River LeaguePreviousNextVolunteer Code of Ethics & Conduct AgreementDuring my tenure as a volunteer Farmington Baseball U.A. I pledge to: 1. Cooperate with all participants involved with the activity. This includes officials, coaches, participants, parents and spectators. 2. Never physically, verbally or emotionally harm, hurt, humiliate or intimidate another participant, coach, parent or official. Never show frustration in the presence of players, parents, spectators, etc. 3. Never use profanity or language that is in bad taste. 4. Listen to and follow all direction from program directors and officials. 5. Communicate to all participants, players, parents, spectators and officials in a friendly and reasonable manner. 6. Respect all facilities, fields and equipment. 7. Participate to the best of my ability and in a safe and professional manner at all times. 8. Review and provide basic first aid principles if needed. Review/complete concussion awareness documents/training and be on the look-out for signs and symptoms while children are under my supervision. 9. Be knowledgeable of league rules, and communicate them to my players and parents as needed. 10. Demonstrate and require fair play and sportsmanship from your players at all times. Lead by example by demonstrating respect and class toward your opponent at all times. 11. Provide an environment that is free from aggressive behavior, violence, drugs, tobacco and alcohol. 12. Place the emotional and physical wellbeing of players and others ahead of a personal desire to win. 13. Treat each player as an individual, taking into account the large range of emotional and physical development for youth age groups. 14. Always remember that I am a youth sports volunteer, and that the game is for children and not adults. If I cannot participate according to this Code of Conduct and/or league rules, then depending on the seriousness of the offense(s), I understand that any, or all, of the following disciplinary actions may occur: – Verbal warning and written documentation – Immediate removal from activity including facility – Temporary suspension from participation including attendance at activity and/or facility – Suspension from the activity and/or facility (no refund, full or partial, of registration fee) – Indefinite Expulsion from all activities and facilities (no refund, full or partial, of registration fee). With my signature, which I voluntarily affix to this contract, I acknowledge that I have read, understood, and will do my best to fulfill the promises made herein. Volunteer Code of Ethics & Conduct Agreement *I have read and agree to the Volunteer Code of Ethics & Conduct AgreementSignature * Clear Signature PreviousNextConcussion and Head Injury Information: Player Concussion AgreementAs an Athlete it is important to recognize the signs, symptoms, and behaviors of concussions. By signing this form you are stating that you understand the importance of recognizing and responding to the signs, symptoms, and behaviors of a concussion or head injury. Parent Agreement: I have read the Parent Concussion and Head Injury Information and understand what a concussion is and how it may be caused. I also understand the common signs, symptoms, and behaviors. I agree that I must be removed from practice/play if a concussion is suspected. I understand that it is my responsibility to seek medical treatment if a suspected concussion is reported to me. I understand that I cannot return to practice/play until providing written clearance from an appropriate health care provider to my coach. I understand the possible consequences of returning to practice/play too soon. Athlete Concussion Agreement *I have read the Parent and Athlete Concussion and Head Injury InformationAthlete Name *FirstLastAthlete Signature * Clear Signature Date *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Have You ever had a concussion? *Yes.No.If Yes. How many concussions? *Have You ever experienced symptoms? *Yes.No.Did you report them? *Yes.No.Athlete Signature * Clear Signature PreviousNextAMATEUR ATHLETIC WAIVER AND RELEASE OF LIABILITYRELEASE OF LIABILITY -READ BEFORE SIGNING!In consideration of being allowed to participate in any way as a member of any team of Farmington Baseball UA, its related events and activities, I (name of participant, player) the undersigned, acknowledge, appreciate, and agree that: 1. The risk of injury and illness resulting from the activities involved in this program is significant, including the exposure to, or potential for infections, including but not limited to influenza, COVID-19, MRSA, as well as permanent paralysis and death, and while particular skills, equipment, and personal discipline may reduce this risk, the risk of serious injury and illness does exist; and, 2. 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 participation; and, 3. I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I’m aware of or observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of my team’s field manager and Farmington Baseball UA immediately; and, 4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE, INDEMNIFY, AND HOLD HARMLESS Farmington Baseball UA, their officers, officials, general managers, field managers, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and, if applicable, owners and lessors of premises used for the activity (“Releasees”), WITH RESPECT TO ANY AND ALL ILLNESS, INFECTIOUS DISEASE, INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law.I 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.Athlete Amateur Athletic Waiver and Release of Liability *I have read the Parent and Athlete Amateur Athletic Waiver and Release of LiabilityPlayer Name (over 18) *FirstLastPlayer Name (over 18) Signature * Clear Signature PreviousNextREVIEW AND SUBMITALMOST DONE! You have the opportunity to review all of your entries and go back and make any changes. Once your registration is submitted and payment received. You will receive emails from the flames keeping you informed on the upcoming season. You will receive an email from your coach or coaches once teams are formed. Any question fee free to use the contact form and some will get back to you as soon as possible. Thank you for choosing the Farmington Flames! Do you have a special request or comment? *Yes.No.Enter Request or Comment Below. Visual Code Updating preview…This is a preview of your submission. It has not been submitted yet! Please take a moment to verify your information. You can also go back to make changes.PreviousSubmit Registration