HICKORY GROVE UNITED METHODIST CHURCH

YOUTH BASKETBALL REGISTRATION FORM

 

Mission Statement: To provide a Christian recreational atmosphere for fellowship and fun, to learn and to grow in our mission to inspire, reach and support Hickory Grove and surrounding communities.

Please print:

 

___________________________________              _______________________________________  Girl: ____ Boy: ____

Child’s First Name                                                               Last Name

 

____________________________________________________________________ Check all that apply:

Street Address                                                                                                                                     Member  _____

                                                                                                                                                                Non-Member        _____

____________________________________________________________________ I would like more

City                                                          State       Zip                                                                         information about HGUMC                _____   

____________________________________________________________________ Registration

E-mail address                                                                                                                                      Requirements

                                                                                                                                                                1 - Completed form              

_____________________               __________________________      ­­­­­­­­­_______________          2 - Registration fee

Home Phone #                      Child’s Date of Birth                           Current Age                           3 - Birth certificate copy

(for 12, 14, 18 and under)

_____________________________________________________________________________________________

Father’s Name                      Cell/Work #                           Mother’s Name                                                    Cell/Work #

 

Medical Information about the child:

Medications regularly taken:                                                                                                                                                            

Reason for taking medications:                                                                                                                                                        

Allergic reactions:  Bee Sting: ___________  Penicillin: __________  Other:                                                                        

Any specific activities to be restricted?                                                                                                                                          

Other health information:                                                                                                                                                                   

I, the undersigned parent or legal guardian of the above named child, hereby gives approval to his or her participation in any and all of the activities of the program during the current season.  I assume responsibility for the transportation of my child to and from activities.  I further understand that neither the participating church nor the league in which the candidate participates, carries medical insurance and in the event my child is injured during any activity related to church or league play, I am solely responsible for any medical bills incurred. I understand that my child will be ineligible to practice and play in this sports program until a copy of the birth certificate is provided, a completed registration form is on file and registration fees have been paid. Misrepresentation of a child’s age or birth date will result in his or her suspension from the league. Each participant must sign the players code of conduct attached to this form or available for download from the Internet.

 

I have provided accurate medical information on my child and understand that medical expenses incurred while participating in this sport are my responsibility.

 

Parent or Guardian Signature: ______________________________________________    Date: ________________

FEE AMOUNT DUE WITH REGISTRATION:               Make checks payable to HGUMC Recreation.

Mail to 6401 Hickory Grove Rd., Charlotte, NC 28215 or turn into the church office. 704-537-4686

Mini Basketball (5-6)                                         $60

Youth Basketball                                                 $80

$5 discount per child if two or more children are participating in same sport.

FIANCIAL ASSISTANCE IS AVAILABLE. YOUR REQUEST WILL BE KEPT CONFIDENTIAL.

 

Shirt Size: (Please check one)

Youth  ____ S     ____ M    ____ L      ____ XL

Adult  ____ S      ____ M    ____ L      ____ XL    ____ XXL

Boys and girls ages five (5) through age seventeen (18) are eligible to participate.

 

All coaches and players participating in sports with Hickory Grove UMC will promote Christian sportsmanship by both words and actions. This contract is to be signed and stapled to the registration form.

Player’s Code of Conduct:

As a team member representing HGUMC, I will:

Do my best to conduct myself in a Christian-like manner at all times. Show respect for all coaches, umpires, officials and team members. Not use profanity or display a bad attitude. Give my best to my coach and team during all practices and games. Take care of any uniform or equipment issued to me. Do my best to be on time for all practices and games. Keep my ball fields clean by putting all trash in the trash bins. I understand that if I fail to abide by this contract, my coach has the right to restrict my playing time as the consequence for violating this contract. If violations continue, the coach has the right to dismiss me from the team.

 

Player’s Signature:                                                                                                               Date:                                      

 

Parent’s Signature:                                                                                                              Date:                                      

(if player is under 18 years of age)

 

The recreation department at Hickory Grove United Methodist Church would like to extend an offer to our membership, their families, and all non-members participating in our recreational programs with an opportunity to serve through volunteer efforts.

 

Please check the volunteer opportunities that interest you:

__________ Coaching Youth Sports                                                                              __________ Officials

__________ Coaching Adult Sports                                                                               __________ Scorekeepers/clock

__________ Interested in helping with a team but not as a Head Coach                 __________ Concessions

__________ Individual Sports Coordinator

Fund raisers Concession stand work at:

__________ Speedway Races (May) __________ Auto Fair (April and Sept.)                    

               

 

 

 

Recreational questions should be directed to Recreation Ministries at the main church number, 704-537-4686, extension 45. Recreation Ministries, Hickory Grove UMC, 6401 Hickory Grove Rd., Charlotte, NC 28215

email rec@hgumc.com