Duchesne City Recreation
             
Duchesne Recreation T-Ball and Coach Pitch 2019
For kids between 3-8 years old
Kids must be 3 by June 4, 2019
T-Ball Age Group: 3-5 years old
Coach Pitch Age Group: 6-8 years old
Early-bird Registration is May 1 - 27 2019, $40
Late Registration after May 27, $55

T-ball will play on Wednesday nights at 5:30
Coach Pitch will play Tuesday & Thursday nights at 5:30

Registration fees cover jersey, hat, and equipment (helmets & bats)
All registrations will be done online at duchesnecity.com and all fees must be paid in full at the time of registration.

If you want a team picture, there will be an extra $15.00 on top of the registration fee.
Please contact Aubrey Evans at 815-540-1480 for any questions.
Baseball will start the week of June 3rd - 7th and all games and practices will be held in Duchesne.


Registration:   $40.00   Quantity:   Item Subtotal:  
$0.00
Participant's First and Last Name [1]
I am registering for [1]
Gender [1]
Age [1]
Jersey Size [1]
Teammate Request [1]

Participant's First and Last Name

[2]
I am registering for [2]
Gender [2]
Age [2]
Jersey Size [2]
Teammate Request [2]

Participant's First and Last Name

[3]
I am registering for [3]
Gender [3]
Age [3]
Jersey Size [3]
Teammate Request [3]

Participant's First and Last Name

[4]
I am registering for [4]
Gender [4]
Age [4]
Jersey Size [4]
Teammate Request [4]

Participant's First and Last Name

[5]
I am registering for [5]
Gender [5]
Age [5]
Jersey Size [5]
Teammate Request [5]

Participant's First and Last Name

[6]
I am registering for [6]
Gender [6]
Age [6]
Jersey Size [6]
Teammate Request [6]

Participant's First and Last Name

[7]
I am registering for [7]
Gender [7]
Age [7]
Jersey Size [7]
Teammate Request [7]

Participant's First and Last Name

[8]
I am registering for [8]
Gender [8]
Age [8]
Jersey Size [8]
Teammate Request [8]

Participant's First and Last Name

[9]
I am registering for [9]
Gender [9]
Age [9]
Jersey Size [9]
Teammate Request [9]

Participant's First and Last Name

[10]
I am registering for [10]
Gender [10]
Age [10]
Jersey Size [10]
Teammate Request [10]
Picture(s):   $15.00   Quantity:   Item Subtotal:  
$0.00

T-ball picture day will be on June 5th.

Pictures for Coach Pitch will be on June 11th

Total:
$0.00
 

Parent/Guardian Information
First Name: Last Name:
Address:
Address:
City: State/Province: ZIP/Postal Code:
Phone: Email:
I am willing to:
Coach
Assistant Coach
Team Parent
I am not able to help at this time.
In Emergency Notify
Emergency Phone Number
 
Payment Information
Method of Payment:
Update name from Parent/Guardian Information
Name of Individual
on Checking Account:
Name of Individual
on Savings Account:
Name of Business
on Checking Account:
Bank Routing Number:
Bank Account Number:
Credit Card Number:
Expiration Date: /
Card ID (CVV2/CID) Number: What is the Card ID?
Cardholder Information (exactly as it appears on your statement)
  Update from Parent/Guardian Information
Cardholder's Name:
Billing Street:
Billing ZIP/Postal Code:
 

Release of Liability/Consent Form:

This consent is for the 2019 season. The participants listed above are physically fit and otherwise able to participate in this program. I understand the program will be supervised and I further understand Duchense City Recreation and its employees will not be held liable for any accidental injury incurred while the participants listed above are participating or while being transported to and from games. I authorize emergency treatment for any accident or illness and consent to allow Duchesne City and its volunteers to use their discretion in administering First Aid medical care to all participants listed above.

I Agree
I have read and agree to the above disclaimer
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