Berwyn Heights Boys Girls Club by qem13071

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									Berwyn Heights Boys & Girls Club                                                                                                                                                                                                  2008 Family Registration
                                                                                                                                                                    Valid Calendar Year 2008 for Children Ages 4 though 14
Mother's Name                                                          email address                                                               Home Phone                                                                     Work Phone


Father's Name                                                          email address                                                               Home Phone                                                                     Work Phone


Address                                                                                     Town or City                                                                                                                          Zip Code


Emergency Contact Person                                                                    Relationship to Child                                                                                                                 Emergency Phone


NEW MEMBER REQUIREMENTS*




                                                                                                                                                                                                  Winter Basketball (Dec - Feb)




                                                                                                                                                                                                                                                                                                    (payments made during February registration)
New members must provide BHBGC with:
 - A copy of child's birth certificate




                                                                                                                                                                                                                                                                              Early Bird Discount
                                                                                                                                                                       Fall Soccer (Sep - Oct)
 - A small recent photo of the child




                                                                                                                                                                                                                                               Membership Fee
 - A completed Yellow County ID Card (obtained at registration)
 - A completed White County Registration Form (obtained at registration)




                                                                                                              Spring Baseball




                                                                                                                                                                                                                                                                (Per Child)
 - A completed Family Registration Form (this form)




                                                                                                                                 Spring Softball
                                                                                              Spring Soccer




                                                                                                                                                    Spring T-Ball
*Registrations will not be accepted unless the above items are submitted together
To obtain Yellow County ID card and White County Registration Form
                            Contact: Ronnie Compton
                             Phone: 301-345-2661
                               email: ronald.compton@verizon.net
        Child's Last Name                   Child's First Name              Birth Date
                                                                                                    √ Please check the sports in which your child is interested
           (Please print)                      (Please print)               Mo/Day/Yr
1.
                                                                                                                                                                                                                                                     $70                             ($10)

2.
                                                                                                                                                                                                                                                     $60                             ($10)

3.
                                                                                                                                                                                                                                                     $60                             ($10)

4.
                                                                                                                                                                                                                                                   FREE                                N/A

I understand and agree with my signature to the following:                                                                                                                                                                                    Memb. Total   Disc. Total
1) In order for my children to be eligible for sports participation for the calendar year 2008, I must register my family via this form                                                                                                      $            $
   and pay any applicable fees.
2) My children listed above have my consent to join the Berwyn Height Boys and Girls Club.                                                                                                                                                    ($190 Max)                      (-$30 Max)
3) The BHBGC does not assume any responsibility for any accidents, or any medical, dental, hospital or other expense incurred                                                                                                                  TOTAL AMOUNT DUE
   while traveling to or from, or participating in, club activities.
4) I waive any claims against the BHBGC or any of its agents in the event of an accident to any of my children listed above.                                                                                                                 $______________
5) I am responsible for any uniform my child receives, and if I fail to return the uniform within 2 weeks of the completion of that                                                                                                                                ($190 Max)
   sport season, I will be expected to pay $30 toward the replacement of the uniform.                                                                                                                                                        o Cash
6) Games involving Berwyn Heights teams may be videotaped and shown on the Berwyn Heights cable TV channel.
                                                                                                                                                                                                                                             o Check # ____________
Parent Signature (required for membership)                                                  Date                                Interest in Coaching or Volunteering:
                                                                                                                                                   Yes ___                                       No ___




Received by                                                            Date                 Birth Certificate                                      Picture                                       White Card                                  Yellow Card
Berwyn Heights Boys & Girls Club                                                                                                                                                                                                                                               2009 Family Registration
                                                                                                                                                                                       Valid BHBGC Sports Year 2009 for Children Ages 4 though 14
Mother's Name                                                         email address                                                                                                   Home Phone                                                                               Work Phone


Father's Name                                                         email address                                                                                                   Home Phone                                                                               Work Phone


Address                                                                                   Town or City                                                                                                                                                                         Zip Code


Emergency Contact Person                                                                  Relationship to Child                                                                                                                                                                Emergency Phone


NEW MEMBER REQUIREMENTS*




                                                                                                                                                                                                                                               Winter Basketball (Dec - Feb)
                                                                                                                        Spring Baseball (Mar - June)




                                                                                                                                                                                                                                                                                                                                                                                         (payments made during February registration)
New members must provide BHBGC with:




                                                                                                                                                       Spring Softball (Mar - June)




                                                                                                                                                                                                                                                                                              (Spring Mar - May Fall Oct - Feb)
                                                                                            Spring Soccer (Mar - May)




                                                                                                                                                                                       Spring T-Ball (Mar - June)
 - A copy of child's birth certificate




                                                                                                                                                                                                                                                                                                                                                                   Early Bird Discount
                                                                                                                                                                                                                    Fall Soccer (Sep - Oct)
 - A small recent photo of the child




                                                                                                                                                                                                                                                                                                                                    Membership Fee
 - A completed Yellow County ID Card (obtained at registration)
 - A completed White County Registration Form (obtained at registration)




                                                                                                                                                                                                                                                                                                                                                     (Per Child)
 - A completed Family Registration Form (this form)




                                                                                                                                                                                                                                                                               Cheerleading
*Registrations will not be accepted unless the above items are submitted together
To obtain Yellow County ID card and White County Registration Form
                            Contact: Ronnie Compton
                             Phone: 301-345-2661
                               email: ronald.compton@verizon.net
        Child's Last Name                  Child's First Name             Birth Date
                                                                                                         √ Please check the sports in which your child is interested
           (Please print)                     (Please print)               Mo/Day/Yr
1.
                                                                                                                                                                                                                                                                                                                                          $75                           (-$10)

2.
                                                                                                                                                                                                                                                                                                                                          $65                           (-$10)

3.
                                                                                                                                                                                                                                                                                                                                          $65                           (-$10)

4.
                                                                                                                                                                                                                                                                                                                                        FREE                                N/A

I understand and agree with my signature to the following:                                                                                                                                                                                                                                                                         Memb. Total   Disc. Total
1) In order for my children to be eligible for sports participation for the BHBGC Sports year 2009, I must register my family via this form                                                                                                                                                                                       $            $
   and pay any applicable fees.
2) My children listed above have my consent to join the Berwyn Height Boys and Girls Club.                                                                                                                                                                                                                                         ($205 Max)                      (-$30 Max)
3) The BHBGC does not assume any responsibility for any accidents, or any medical, dental, hospital or other expense incurred                                                                                                                                                                                                       TOTAL AMOUNT DUE
   while traveling to or from, or participating in, club activities.
4) I waive any claims against the BHBGC or any of its agents in the event of an accident to any of my children listed above.                                                                                                                                                                                                      $______________
5) I am responsible for any uniform my child receives, and if I fail to return the uniform within 2 weeks of the completion of that                                                                                                                                                                                                                     ($205 Max)
   sport season, I will be expected to pay $30 toward the replacement of the uniform.                                                                                                                                                                                                                                             o Cash
6) Activities involving BHBGC members may be videotaped and shown on the Berwyn Heights cable TV channel, along with photos
   being placed on the BHBGC web site.(www.bhbgc.org)                                                                                                                                                                                                                                                                             o Check # ____________

Parent Signature (required for membership)                                                Date




Interest in Coaching or Volunteering:                                 If YES for coaching, which sport? _________________________________
             Yes ___            No ___
                                                                      If YES for volunteering, then for:
                                                                      BHBGC Board ____            Events ____                                                                         Concession Stand ____                                                                                                                       Other ____

Received by                                                           Date                Birth Certificate                                                                           Picture                                                 White Card                                                                          Yellow Card


                                                                             web site: www.bhbgc.org
Berwyn Heights Boys & Girls Club                                                                                                                                                                                                                                                                                        2010 Family Registration
                                                                                                                                                                                                                               Valid BHBGC Sports Year 2010 for Children Ages 4 though 16
Mother's Name:                                                                  Email Address:                                                                                                                                 Home Phone:                                                                              Work Phone:


Father's Name:                                                                  Email Address:                                                                                                                                 Home Phone:                                                                              Work Phone:


Address:                                                                                             Town or City:                                                                                                                                                                                                      Zip Code:


Emergency Contact Person:                                                                            Relationship to Child:                                                                                                                                                                                             Emergency Phone:


NEW MEMBER REQUIREMENTS*




                                                                                                                                                                                                                                                                                        Winter Basketball (Dec - Feb)
                                                                                                                                                                 Spring Baseball (Mar - June)




                                                                                                                                                                                                                                                                                                                                                                                                  (pay this amount on first 2 weeks of Febuary)
New members must provide BHBGC with:




                                                                                                                                                                                                Spring Softball (Mar - June)
                                                                                                                                    Spring Soccer (Mar - May)




                                                                                                                                                                                                                                Spring T-Ball (Mar - June)




                                                                                                                                                                                                                                                                                                                          (Sept - Feb)
 - A copy of child's birth certificate




                                                                                                       Ball Hockey (July - Aug)




                                                                                                                                                                                                                                                                                                                                                                            Febuary Registation
                                                                                                                                                                                                                                                             Fall Soccer (Sep - Oct)
 - A small recent photo of the child




                                                                                                                                                                                                                                                                                                                                             Membership Fee
 - A completed Yellow County ID Card (obtained at registration)
 - A completed White County Registration Form (obtained at registration)




                                                                                                                                                                                                                                                                                                                                                                                 Discount
                                                                                                                                                                                                                                                                                                                                                              (Per Child)
 - A completed Family Registration Form (this form)




                                                                                                                                                                                                                                                                                                                         Cheerleading
*Registrations will not be accepted unless the above items are submitted together
To obtain Yellow County ID card and White County Registration Form
                            Contact: Ronnie Compton
                              Phone: 301-345-2661
                                email: ronald.compton@verizon.net
        Child's Last Name                  Child's First Name          Gender        Birth Date
                                                                                                                                  √ Please check the sports in which your child is interested
           (Please print)                     (Please print)             M/F         Mo/Day/Yr
1.
                                                                                                                                                                                                                                                                                                                                                 $105                                $85

2.
                                                                                                                                                                                                                                                                                                                                                 $105                                $85

3.
                                                                                                                                                                                                                                                                                                                                                 $105                                $85

4.
                                                                                                                                                                                                                                                                                                                                                 FREE                              FREE

I understand and agree with my signature to the following:                                                                                                                                                                                                                                                                                Memb. Total                           Disc. Total
1) In order for my children to be eligible for sports participation for the BHBGC Sports year 2010, I must register my family via this form
    via this form and pay any applicable fees
                                                                                                                                                                                                                                                                                                                                         $                                  $
2) My children listed above have my consent to join the Berwyn Height Boys and Girls Club.
3) The BHBGC does not assume any responsibility for any accidents, or any medical, dental, hospital or other expense incurred while                                                                                                                                                                                                                       County Fee
    incurred while traveling to or from, or participating in, club activities.
4) I waive any claims against the BHBGC or any of its agents in the event of an accident to any of my children listed above.
                                                                                                                                                                                                                                                                                                                                                         $20 x ______
5) I am responsible for any uniform my child receives, and if I fail to return the uniform within 2 weeks of the completion of that sport                                                                                                                                                                                                    (per child including 4th
    sport season,I will be expected to pay $30 toward the replacement of the uniform                                                                                                                                                                                                                                                                  child)
6) Activities involving BHBGC members may be videotaped and shown on the Berwyn Heights cable TV channel, along with photos                                                                                                                                                                                                                  TOTAL AMOUNT DUE
    with photos being placed on the BHBGC web site. (www.bhbgc.org)
                                                                                                                                                                                                                                                                                                                                         $______________
Parent Signature (required for membership):                                                                                       Date
                                                                                                                                                                                                                                                                                                                                         o Cash
                                                                                                                                                                                                                                                                                                                                         o Check # ____________

Interest in Coaching or Volunteering:                                           If YES for coaching, which sport(s)?
           Yes: ______          No: ______
                                                                                If YES for volunteering, then for:
                                                                                BHBGC Board ____                                                                Events ____                                                    Concession Stand ____                                                                                     Other ____

Received by                                                                     Date                                              Birth Certificate                                                                            Picture                                                 White Card                                        Yellow Card


                                                                                             web site: www.bhbgc.org

								
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