OUTDOOR BLACKTOP

BASKETBALL Coed Ages: 9-12, 13-15 (age as of 09/01/2021)

Registration Fee: $35

*Birth Certificate Required*

3 Easy Ways to Register: KICKBALL ONLINE ∙ BY MAIL ∙ IN PERSON

Online: Coed Ages: 5-7, 8-10, 11-14 (age as of 09/01/2021) nashcounty.recdesk.com/community Registration Fee: $35 *Birth Certificate Required* By Mail with check or money order: Nash County Recreation TACKLE FOOTBALL 2021 Summer Youth 120 W. Washington Street, Suite 3040 & CHEER Sports Nashville, NC 27856 Registration: Now - June 4th

Rookie Ages: 6-8 (age as of 08/01/2021) **Unless otherwise stated** In Person: JV Ages: 9-10 (age as of 08/01/2021) ———————————————————————- Nash County Recreation Varsity: Ages 11-12 (age as of 08/01/2021) Outdoor Blacktop Basketball, 120 W. Washington Street, 3rd Floor Registration Fee: $40 Kickball, Outdoor Volleyball, Nashville, NC 27856 **Registration Ends June 15th** Football & Cheer *State issued ID Required for football* League & *Travel to other locations will be required* Individual Team OUTDOOR Sponsorship Opportunities VOLLEYBALL We are seeking business sponsors for our Coed Ages: 10-12, 13-15 (age as of 09/01/2021) upcoming spring season.

Please contact the Main office Register Fee: $35

at 252-462-2628 for further information. *Birth Certificate Required* REGISTRATION FEE: 2021 YOUTH SUMMER SPORTS REGISTRATION $35 (Basketball, Kickball, Volleyball) $40 (Football) Name of Participant ______Date of Birth ______Age ____ Sex (M) ____(F) ____

Address of Participant ______**Refunds cannot be requested after jerseys orders has been place on June 5th.** Email Address______Shirt/Jersey Size (YXS-AXXXL)______GAME & PRACTICE LOCATIONS Sport ______Practice Location: ______

Parent/Guardian: ______Phone: Home ______(C)/(W)______SUMMER BLACKTOP BASKETBALL WB Ennis Park - Red Oak Parent/Guardian: ______Phone: Home ______(C)/(W)______JW Glover Memorial Park - Nashville School Attending ______School Grade ______Miracle Park @ Coopers - Elm City Are you interested in volunteer coaching? ____ Yes ____ No Spring Hope Community Park—Spring Hope KICKBALL RELEASE AND CONDUCT STATEMENT WB Ennis Park - Red Oak I hereby give my child permission to participate in the sport/event listed above. I know that with any sport there is possibility of serious injuries. I, therefore, will JW Glover Memorial Park - Nashville assume all responsibilities for any accident or injury that may occur and hold Nash County harmless for such accident or injury. I understand that any athletic or other type of equipment issued to him/her belongs to the Recreation Department and that he/she is responsible for it. When he/she stops participating in said TACKLE FOOTBALL event, I will see that he/she returns any and all equipment. I also understand fully that the Recreation Department will not tolerate unsportsmanlike behavior of JW Glover Memorial Park - Hornets any kind. I agree that any such behavior, such as cursing and/or yelling at officials/coaches, staff etc., will result in suspension from the Department’s activities for me and/or my child. WB Ennis Park—Northern PHOTO RELEASE STATEMENT Spring Hope Community Park—Southern OUTDOOR VOLLEYBALL Pictures and/or video clips will be taken while participating in Nash County Recreation programs. Contact our main office at(252) 462-2628 if you have questions or concerns regarding this statement. WB Ennis Park - Red Oak

REFUND AND RETURNED CHECK POLICY 100% refund/credit/transfer if Department cancels program or facility rental. 100% fee transfer to another P&R program within the same calendar year. NO GAME & PRACTICE DAYS REFUND if participant’s request falls after registration ends. There is a $25 fee for all checks returned.

SUMMER BLACKTOP BASKETBALL Weekdays & Saturday’s Signed______Date ______KICKBALL (Signature of Parent of Guardian) Weekdays TACKLE FOOTBALL Weekdays & Saturday’s

OUTDOOR VOLLEYBALL WB Ennis Park - Red Oak

[For Administration Use Only]

Payment Method: ______Amount: ______Receipt Number______