Belle Vernon Area High School Baseball Teams

2019 BVA BASEBALL REGISTRATION FORM - FOR ALL LEVELS AND PROGRAMS BVA OFFERS

Instructions: Please complete all items contained on this form. There are several pages for you to complete. Please sign each section electronically after it is completed.

Be completing this form, you have registered for all programs offered by the BVA HS Baseball Program. This form only needs to be completed once every school year,

Thank you.

* Player's name as it appears on his BIRTH CERTIFICATE:

This name or nickname that this player would like to be called.:

Father's First and Last Name:

Mother's First and Last Name:

* Select the BVA School You Are Attending This School Year:

* Please select your class this school year:

Personal Information

Home Address

* Street Address:

* PA City, Township or Borough:

* Zip Code:

Birth Record

* Date of Birth:

* Place of Birth: (city and state):

Player and Parent Contact Information

All player's and parent's email addresses will be added to the teams' mass email list.

Player's Home Telephone Number:

Player's Personal Cell Phone Number:

Father's Cell Phone Number:

Mother's Cell Phone Number:

* Team Text Alerts:

* Player's Email Address:

Father's Email Address:

Mother's Email Address:

Player's physical information that is needed for the team roster. This information will be listed on the team website, on GameChanger and MaxPreps. It also will be emailed to professional scouts and to college coaches.

* Bats::

* Throws:

* Height (feet and inches) Type 5.08 for 5 feet 8 inches or 5.10 for 5 feet 10 inches):

* Weight:

Do you wear contacts?:

Do you wear glasses?:

Information Needed for Ensuring that the Requirements of the PIAA concerning Physicals were met and the CIPE Form has been completed

I had a physical for a fall sport in June, 2018 during school when it was offered.:

I had or will get the required physical for winter and spring sports when offered by the school in November, 2018:

I will get or need to get a physical for baseball to meet the PIAA requirement? You can get this physical at any time after June 1, 2018. The appropriate forms CIPE can be downloaded from the handout section of the team website.:

I am or am going to play a sport sponsored by the BVA school district in the fall or winter. Therefore you have submitted the required sports physical forms signed by your family doctor? If so, for what sport did you have the physical?

* Please select the fall sport for which you met the requirement for physicals.:

* Please select the winter sport you will or have tried out for to met the requirement for physicals.:

* Did you have an injury during your fall or winter season that ended your participation on the team. If you did you will need to be re-certified by a physician.:

BVA requires that an IMPACT test is taken every two years for all students participating in athletics. For example, if you first had an IMPACT test as a seventh grader, you will need to take another impact test as a Freshman. Your will then need to take another impact test as a Junior.

* In what year did you last have the required IMPACT test from Mr. Ferreri?:

Information Needed for Organizing Winter Workouts, Tryouts and Practices

* What is your best position including catching? This does not include pitchers.:

* Is this the position (other that pitching) that you will be playing when trying out for the team?:

* Please select an alternate position to learn in our winter program. This does not include pitching.:

* Are you willing to move to a position that the coaching staff feels best suits your abilities?:

* Are you a pitcher? Do you want to pitch for BVA High School?:

If the above answer was yes, are your right-handed or left-handed?:

* If you have not pitched in the past, would you be willing to learn to pitch?:

Information Concerning Your Playing Experience This Year

* What summer league team (s) did you play for this summer (2018)?:

* What was your level of play last summer?:

* What was the name of your summer league coach?:

Belle Vernon Area Fall Baseball Program

The Belle Vernon Area coaching staff provides a fall baseball program for the members of our baseball program. You do not have to have the required CIPPE physical to participate in the fall program. However, parents should make sure that their sons are physically able to participate.

A fee is charged to each player that participates.The fee will be announced when the final cost of the program is determined. Players may get 5, $25 sponsors in lieu of the registration fee. Players that played in the middle school program last season are eligible for the JV Team. Players entering seventh grade that plan to play middle school baseball are also eligible to play on the fall JV team.

* Are you going to play for the BVA Fall Baseball Program this year?:

If you are not playing for a BVA fall team, what team are you planning to or did you play on this fall?:

If you know, what is the name of your fall league coach?:

Uniform Information

* Hat Size:

* Shirt Size:

* Waist Size (in even number inches):

Belle Vernon Area High School

Leopard Baseball Parent/Guardian/Grandparent Regulation

Section TH-A, Team Policies and Procedures; page 14 of the Baseball Handbook
Policy XVII, Part D, #1 - #5 and Part E, #1 - #6:

Belle Vernon Area Baseball Team Policies can be found in the team handbook and also in the handout section of the team website. All players and their parents should carefully read the team policies before electronically signing this document.

Signing this document is required before our winter program begins. Returning this form electronically through the team website confirms that all parties are aware of the team policies and agree to abide by them.

The excuse that I did not know the policy by players, parents/guardians or other family members will not be accepted.

The policy states that any time a player's parent/guardian or other family member comes onto the field during either a practice or game to register a complaint with respect to the playing time and.or status of said player, an immediate suspension from the team will result.

The field is defined as any area that is not designated as an area for spectators.

A player, parent/guardian may request a meeting with the coaching staff (by contacting the head coach by telephone only) to discuss the player's status with the team. This meeting will not be conducted on the day of a game nor in the vicinity of the playing field.

I also understand the policy and consequences associated with Section E concerning social media and texting.

Under no circumstances will a player, parent/guardian confront any coach on the staff or other team member for discussing the player's status outside of this granted meeting.

This policy includes the all program, our winter conditioning program and all levels or our spring program.

By signing this form and returning it to dhixenbaugh@zoominternet.net via email through the team's website, you are indicating that this is a legal and binding signature electronically.

* Player's Signature:

* Date of Player's Signature:

* Signature of Student/Athlete's Parent/Guardian:

* Date of Signature:

Signature of Student/Athlete's Parent/Guardian:

Date of Signature:

Injury Waiver Form

For the 2018 Belle Vernon Area Baseball Fall Baseball Program and the 2018-2019 Winter Program and all In Season Programs - Middle School through High School

Parents and Student Athletes:

The Fall Baseball Program as well as the Winter program at Belle Vernon Area includes conditioning (running, plyometrics, weight lifting) as well as the development of the basic skills of baseball. These activities are extremely strenuous in nature.

If for any reason you (your son) cannot participate in strenuous physical activities or if you (your son) have any physical limitations, please contact the head baseball coach by email at (dhixenbaugh@zoominternet.net) explaining these limitations. Please be aware that only the baseball coaches at Belle Vernon Area will be made aware of these limitations.

In consideration of the Belle Vernon Area School District and/or the coaching staff permitting me to participate in the Fall Baseball Program and the Winter Baseball Program, I hereby assume all risks associated with participation and agree to hold the Rostraver Youth Baseball Association (fall baseball program) or the Belle Vernon Area School District, its employees, agents, representatives, coaches, and volunteers harmless from any and all liability, actions, causes of action, debts, claims, or demands of any kind and nature whatsoever which may arise by or in connection with my participation in either the Fall Baseball Program, the Winter Baseball Program, and the Spring Baseball Programs. The terms hereof shall serve as a release and assumption of risks for my heirs, estate, executor, administrator, assignees, and all members of my family.

* Player's Signature:

Date of Signature:

In consideration of the Belle Vernon Area School District permitting my son to participate in the Winter Baseball Program, I hereby assume all risks associated with participation and agree to hold the Belle Vernon Area School District, its employees, agents, representatives, coaches, and volunteers harmless from any and all liability, actions, causes of action, debts, claims, or demands of any kind and nature whatsoever which may arise by or in connection with his participation in the Winter Baseball Program. The terms hereof shall serve as a release and assumption of risks for my heirs, estate, executor, administrator, assignees, and all members of my family.

* Signature of Student/Athletes Parent/Guardian:

Date of Signature:

Signature of Student/Athlete's Parent/Guardian:

Date of Signature:

By signing this form and returning it to dhixenbaugh@zoominternet.net via email through the team's website, you are indicating that this is a legal and binding signature electronically.

Each student athlete is required to complete the form below when they receive their physical to meet the PIAA requirements. In the case of an injury in our winter program as well as during the upcoming season, the coaching staff would like to keep a copy of the form on file in the warehouse in case of an emergency.

Affixing you name and dating the document through the team website makes this a legal and binding document, signed electronically.

The information on this page will be kept private and confidential as required by HIPPA laws and will only be used in the case of an emergency!

PERSONAL AND EMERGENCY INFORMATION FOR THE BASEBALL PROGRAM

* Student’s Name:

* Age of Student on Last Birthday::

* Grade for Current School Year::

* Male/Female:

* Date of Student’s Birth::

* Current Physical Address:

* Current Home Phone #:

* Parent/Guardian Current Cellular Phone #:

EMERGENCY INFORMATION

* Parent’s/Guardian’s Name:

* Relationship:

* Address:

* Emergency Contact Telephone #:

* Secondary Emergency Contact Person’s Name:

* Relationship:

* Address:

* Emergency Contact Telephone #:

PHYSICIAN AND MEDICAL INSURANCE INFORMATION

* Medical Insurance Carrier:

* Policy Number:

* Address:

* Telephone #:

* Family Physician’s Name:

* Type of physician:

* Address:

* Telephone #:

Items An Emergency Physician Might Need to Know

* Student’s Allergies:

* Student’s Health Condition(s) of Which an Emergency Physician Should be Aware:

* Student’s Prescription Medications:

* Signature of Student/Athlete's Parent/Guardian:

Signature of Student/Athlete's Parent/Guardian:

Signature of an Adult Player ( 18 years or older):

Initials of a member of the coaching staff as witness thereof:

Waiver for Participating in Workouts at the BVBF Baseball Performance Center

RELEASE AND WAIVER OF LIABILITY

I/ we (____ name (s) A ____) am/are an adult individual(s), and a player or coach or the parents and/or guardians of (____ name B ____), a minor child, and affiliated with the Belle Vernon High School Baseball Team and I/we hereby enter into this Release and Waiver of Liability ("Release") as of the date appearing below, knowingly, intelligently and of my/our own free will for the purpose of being permitted to use the BVBF BASEBALL PERFORMANCE CENTERFacility, otherwise known as ("Facility"), located at 495 Finley Road, Belle Vernon, Pennsylvania as a baseball practice facility.

* Name (s) A:

* Name B:

WHEREAS, said facility and property is leased by J and J Construction, LLC, a Pennsylvania Liability Company, having its principal place of business at 495 Finley Road, Belle Vernon, Pennsylvania, 15012, ("Landlord");

WHEREAS, I/we understand that J and J Construction, LLC, is permitting The Belle Vernon Baseball Foundation and my/our son to use the facility for the purpose of practicing baseball with the Belle Vernon Area High School Baseball Team and I/we desire to allow my/our child to use the facility;

WHEREAS, as a condition to use this facility, I/we understand that I/we must execute a Release and Waiver of Liability as set forth herein; and

WHEREAS, I/we execute this Release in favor of and for the benefit of the Landlord, J and J Construction, LLC, to evidence my/our assumption of risk and responsibility and release of liability for all matters relating to my/our use of the facility.

NOW THEREFORE, for good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, I/we do hereby understand and agree as follows:

A. The facility is available for the use of the Belle Area High School Baseball Team and its coaches, members and students associated with the team or its members of the team;

B. The use of facility is at the risk of the users of the facility;

C. All users, as a condition to the use of the facility, must sign and issue to Landlord a written Release in
a form and substance acceptable to Landlord;

D. The facility is unsupervised except to the extent that the Belle Vernon Area High School Baseball Team chooses to supervise it at its discretion;

E. All users of the facility, including my/our child, must immediately report any needed equipment change or any unsafe condition in writing to Landlord and the Belle Vernon Area High School Baseball Team;

F. The Landlord, in its reasonable discretion, may change the rules and the hours of the facility at any time and the Landlord reserves the right to deny access to the facility to anyone for any reason, including, but not limited to, misuse of the facility or noncompliance with the rules and regulations of the facility;

G. The Landlord may, without liability whatsoever, discontinue providing the facility at any time;

H. I/We agree to comply with all the rules and regulations relating to the facility;

I. Landlord shall have no liability whatsoever relating to my/our child's participation and involvement with the use of the facility, including his failure to deny access to the facility to anyone including, but not limited to, his knowledge of any defective conditions or dangerous conditions that exist therein.

J. In consideration of being allowed the use the facility, I/we assume full risk and responsibility for all bodily injury, property loss and property damage, including but not limited to injuries arising from or related to use by my/our child or others of equipment, machines, rooms or other matters of the facility; injuries and medical disorders arising from or related to the use of the facility, such as heart attack, stroke, death, heat stress, brain strains, broken bones, torn muscles, tendons, ligaments, accidental injuries or death and any medical expenses, costs or debt incurred as a result of the same, occurring anywhere in the facility and any property loss or damage that may arise or be sustained by my/our child during or related to participation in or involvement in or use of the facility.

K. I/we individually and on behalf of my/our child, do hereby voluntarily assume all risk known and unknown of injuries, loss or damages caused, even if caused in whole or in part by the action, inaction, or negligence of the Released parties, namely J and J Construction, LLC to the fullest extent allowed by law, demands, injuries, damages, actions and causes of action whatsoever and from any and all liability for any loss of property, property damage or personal injury of any kind, nature or description that may arise or be sustained by me/us during or related to participation, involvement with or use of the facility to the extent permitted by law.

L. I/We hereby agree to indemnify and to protect and hold J and J Construction, its agents, servants and employees and owners harmless against any and all actions, claims, demands, liability, costs and expenses arising from the use of the facility by my/our child.

M. I/We understand that this Release shall apply to any claims that I/we do not know or suspect to exist at this time, which may arise in the future despite, and by way of any provision of Pennsylvania law that may suggest that such a claim would void this Release. I further understand that the "Released parties" consist of J and J Construction and its directors, officers, employees, successors and assigns and any subsidiary companies and their representatives, directors, officers, employees, agents, successors and assigns and all other entities and persons managing and maintaining the facility, including without limitation, Edward Burns

N. I/We hereby expressly waive and relinquish every present or future right or benefit I/we have or may have as a result of any of the facts, matters and/or events referred to in this Release under Pennsylvania law to the fullest extent. This Release shall be governed by the laws of the Commonwealth of Pennsylvania and shall not be modified except in writing by and mutually agreed to by the parties.

O I/We represent and agree that I/we have read and understand this Release and that it is binding upon me/us and my/our child and that this release has been relied on by the Landlord in permitting me/us to use this facility.

The form was executed below on the date listed by a parent/guardian of a student of the Belle Vernon Area School District.

This from was executed on the date listed below at Belle Vernon, PA

* Date Form Was Completed and Executed:

* Parent/Guardian Signature:

Parent/Guardian Signature:

Signature of an Adult Player:

Signature of a Member of the Coaching Staff:

2018-2019 Permission To Use Your Picture On the Team Website and On MaxPreps

Pennsylvania School Law prohibits the use of a student or athlete's picture on any school related document without prior permission. By completing this form and checking the appropriate box, you are either giving or denying the coaching staff permission to display your son's photograph, both individually and as part of the team picture on the team website, MaxPreps, or any other team related document.

I give permission to the baseball coaching staff of Belle Vernon Area to display my son's photograph on the team website, MaxPreps, or any other team related document.

I do not want my son's photograph displayed on the team website, MaxPreps, or any other team related document.

* Signature of Student/Athlete's Parent/Guardian:

* Date of Signature:

* Signature of Student/Athlete's Parent/Guardian:

* Date of Signature:

By signing this form and returning it to dhixenbaugh@zoominternet.net via email through the team's website, you are indicating that this is a legal and binding signature electronically.

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2019 BVA BASEBALL REGISTRATION FORM - FOR ALL LEVELS AND PROGRAMS BVA OFFERS