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2. Sport Registering For:
   -- Select One --Youth BasketballTee BallYouth BaseballYouth SoftballAdult VolleyballAdult SoftballYouth CheerleadingYouth FootballYouth Soccer
3. Jersey Size:
   -- Select One --Youth XXSYouth XSYouth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XLAdult XXLAdult XXXL
4. Short Size
   -- Select One --Youth XSYouth SYouth MYouth LAdult SAdult MAdult LAdult XL
5. Pant Size:
   -- Select One --Youth XXSYouth XSYouth SYouth MYouth LYouth XLAdult SAdult MAdult LAdult XL
7. Last Name*
8. First Name*
10. Gender
    -- Select One --MaleFemale
11. Email Address*
13. Street Address*
15. Birthdate*
16. Age prior to September 1st*
18. Primary Contact*
19. Primary's Cell*
21. Secondary Contact
22. Secondary's Cell
24. Does child have any medical issues e.g. allergies, special needs, that we need to be aware of?*
26. Are you interested in Coaching?
    -- Select One --CoachAssistant CoachNot Interested
27. Are you interested in volunteering as needed?
    -- Select One --Referee/UmpireTime/Score KeeperConcessionCleaning BathroomsPicking up TrashCollecting Money at the GateNot Interested
29. Permission*

    1. Yes

    I hereby give permission for my child to participate in the youth sports program sponsored by the Charlton County Recreation Department (CCRD). I understand that there are some risks involved with participation in youth sports programs; in consideration of the benefits which will be realized by my child, I hereby assume all responsibility for all risks and hazards incidental to this program and transportation to and from this program, and do so further release, absolve, indemnify and hold harmless the CCRD, and agency of Charlton County, Georgia, its administrators, officials, supervisors, sponsors, volunteers and all others involved with this program. Pictures may be taken while participating in the CCRD activities for publicity. I hereby acknowledge the ZERO TOLERANCE POLICY in regards to inappropriate behavior and actions at all events and sporting venues. In the event that my child becomes ill or injured during practices or games, I hereby authorize CCRD or a representative of CCRD to consent to first aid or emergency medical treatment for my child.

31. Head coaches will automatically get their child assigned to their team. Sponsor’s child will not be protected. Siblings will be placed on the same team. (Please advise CCRD of any siblings participating at time of registration). If your child does not get selected to play for the team / coach that you wish them to, withdrawing from the program will result in forfeiting your registration fees. Please remember that all of our coaches are volunteers! This is a great opportunity to learn from a new coach. They all have something different and positive to bring to the game.

    All volunteer coaches must complete a background check through the Charlton County Sheriff’s office.

    THERE WILL BE A $10 FEE FOR ANY LATE REGISTRATIONS.  A FEE OF $40 WILL BE CHARGED FOR ALL RETURNED CHECKS.

    Equipment issued to players is to be returned within 10 DAYS of the last game played. Failure to do so will result in the parent being held FINANCIALLY RESPONSIBLE for the replacement of the equipment.

33. Terms & Conditions*

    1. Agreed

    I certify that I have read, understand and accept all of the information and conditions stated on this form and agree that it is my responsibility to abide by the rules and by-laws of CCRD and all state and local laws at any CCRD function.

35. Payment
    👉🏼YOU MUST CLICK HERE TO MAKE PAYMENT ONLINE👈🏼

    Child or Adult registration will not be completed until payment is made. 

    Come back to this page to submit registration form after making payment!!!

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37. 1. Receive an email copy of this form.
38. Email address

    This field is not part of the form submission.

39. Submit Submit and Print

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