2023 SSMBA REGISTRATION (Saugeen Shores Minor Baseball)

Print 2023 SSMBA REGISTRATION

PLAYER INFORMATION

Information regarding player

Participant FIRST name:^*
Participant LAST name:^*

DATE of Birth:^*

Open the calendar popup.

MM/DD/YYYY

Gender^*
Mailing Address:^*
Municipality:^*
Postal Code:^*

PARENT/GUARDIAN OF PLAYER INFORMATION

To be completed by parent or guardian of the registered player.

Parent/Guardian FIRST Name:^*
Parent/Guardian LAST Name:^*
Parent/Guardian contact number^*

123/456/7890
Alternate Phone Number:

123/456/7890
Parent/Guardian Email:^*

all communication will be sent to this email
Parent/Guardian Mailing Address:
SAME as Player
If not the same as player, please complete information below
Mailing Address:
Apt/Unit No:
Municipality:
Postal Code:

REGISTRATION

Please select team that you are registering for

TEAM registering for:^*

PLAYER EMERGENCY CONTACT

Emergency Contact Name:^*
Emergency Contact Phone Number:^*

123/456/7890

VOLUNTEERING

Saugeen Shore Minor Ball Association is a volunteer organization and as such requires the participation of many volunteers. If you or a member of your family would be interested, please indicate below.

I would like to volunteer as a:

Age and Location

With acknowledgement, I agree to abide by the rules of Saugeen Shores Minor Baseball Association. I further certify that the age of my child is correct as printed on this form and that he/she is a bonafide resident of the address given above. I understand that my child is subject to immediate dismissal from the program should the age or address given be inaccurate. I also give permission for my child to participate in the SSMBA program and hold harmless the Saugeen Shores Minor Baseball Association, its members, directors, coaches and other officials and any other person or entity associated with the program from any and all injury or damage for any claims or causes of action whatsoever for any loss or injury suffered by any child and or myself.

I agree to the terms and conditions stated above^*
Participant Images:

By registering your child with SSMBA, you authorize the use of his/her image for promotional purposes of SSMBA. These might include, but are not limited to, use of said image on the SSMBA website or submitted to the local newspaper.

If you do not approve the use of said image, please check the box below and also remind the players coach at the beginning of the season.

I do NOT authorize the use of my child's image:
Rowan’s Law

In May 2013, 17 year old Rowan Stringer died as a result of a head injury she sustained while playing rugby with her high school team. In the week prior to her final game, Rowan had been hit twice, and likely sustained a concussion each time. These concussions were not recognized, and she continued to play. When she was hit again in her last game, she suffered what is known as Second Impact Syndrome – catastrophic swelling of the brain caused by a second injury that occurs before a previous injury has healed. Rowan collapsed on the field and died four days later in hospital.

A coroner’s inquest was convened in 2015 to look into the circumstances of Rowan’s death. The coroner’s jury made 49 recommendations for how the federal government, as well as Ontario’s government ministries, school boards and sports organizations, should improve the manner in which concussions are managed in this province.

Requirements

All Registrants registering July 1, 2019 or after must have completed the review information and acknowledgement prior to registration/participation.

Please select and review the appropriate link for all your children to ensure compliance.

10 and Under Concussion Awareness Resource

11-14 Concussion Awareness Resource

15 and Over Concussion Awareness Resource

As well, the SSMBA Concussion Code of Conduct must be reviewed.

SSMBA_Athlete_Concussion_Code_of_Conduct

I have completed the appropriate review:^*
COVID-19

Please review the COVID-19 Declaration of Compliance and Waiver document and acknowledge completion of review. The clickable link is below.

baseball_ontario_-_waiver__and_declaration_covid-192021-01-22t15-25-58v001_by_292.pdf

I agree to the terms and conditions stated above^*
BASEBALL ONTARIO WOULD LIKE TO CONTACT YOU VIA EMAIL: To improve our communications and service we would like to correspond with you via email. In order to comply with Canadian legislation relating to commercial electronic messages, we are seeking your consent to communicate with you via electronic messages, including email, related to your relationship with Baseball Ontario including team selection, program, membership, promotional materials and other Baseball Ontario information. You may choose not to receive these communications at any time by emailing us at [email protected]

I agree to the terms and conditions stated above^*
Privacy Policy:

Baseball Ontario Privacy Policy

Baseball Ontario Privacy Policy can be found by clicking the link above.

I agree to the terms and conditions stated above^*
Dual Registration:

By completing this form, you are registering with both SSMBA and Baseball Ontario.

Baseball Ontario appoints SSMBA to collect fees on its behalf, included in the registration fee collected through this process. No additional monies is charged to the parent registering locally. Baseball Ontario invoices SSMBA for fees collected.

I agree to the terms and conditions stated above^*
Liability Waiver

On behalf of myself and the player being registered, I recognize that baseball entails serious risks. Consequently, except as noted below, I and the player being registered relinquish all rights to a claim of any kind, including the right to a claim for bodily and material damages, regardless of the cause, against Baseball Ontario, its member associations, including SSMBA and their respective officers, employees, coaches, umpires, assignees, agents, representatives, and sponsors, even if such damages result from negligence of Baseball Ontario, its member associations, including SSMBA and their respective officers, employees, coaches, umpires, assignees, agents, representatives, and sponsors.

Without restricting the generality of the preceding, I and the player being registered also relinquish the right to any claim against Baseball Ontario, its member associations, including SSMBA and their respective officers, employees, coaches, umpires, assignees, agents, representatives, and sponsors resulting from a decision on their part, regardless of the nature of this decision.

This release of Baseball Ontario, SSMBA and the other persons noted above does not preclude myself or the player being registered from making a claim under any sports accident coverage provided by Baseball Ontario and/or SSMBA to their players. An overview of the current sports accident coverage provided by Baseball Ontario can be found at the following link.

oba_insurance_program_overview_2022-20232022-06-15t08-51-58v001_by_292.pdf (baseballontario.com)

I agree to the terms and conditions stated above^*
Refund Policy

Up to and including April 1-Full refund minus $50 admin fee.

Prorated refunds for withdrawl due to medical reasons/COVID-19 may be considered at the discretion of the executive.

I agree to the terms and conditions stated above^*