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St. Louis Patriots Homeschool Baseball Registration 2010 Season

Family Information
Father’s Name:___________________
Father’s Cell Phone (____) _________________
Mother’s Name: __________________
Mother’s Cell Phone (____) ________________
Home Phone: (____)_________________
Work Number (____)____________________
Address: ________________________________________________________ City: ______________________________________ State:___________ Zip_________
Home E-mail Address:______________________________________________
Work E-mail Address: ______________________________________________

Family Insurance Information: Provider_______________________________________
Policy Number:_______________________
Responsible Party: ____________________
Insurance Company Phone Number:_________________________

Player Information:
Player’s Name (First and Last)___________________________________
Date of Birth____________________ Age______
Requested Uniform Number:_____

2009-2010 Declared Grade for playing sports: ________________
(Note this should be the player’s grade for playing sports not necessarily the level of school work. Example: A Sophomore by age may be doing Junior level work).

Player’s positions___________________________________________

SENIORS: Knowing that there is a conflict with the St. Charles Homeschool graduation and the Ft. Wayne National tournament, will player who is graduating attend graduation or the homeschool tournament?___________________________________________________________
(Note that alternate graduation options are available.)

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Definition of Homeschooling (As defined by National Homeschool Baseball Association (NHBA) Ft. Wayne Tournament): “Homeschooling” is defined to mean that a student’s education is parent-directed and the student is taking at least 51% of his classes at home. It is understood that students may have the opportunity to take dual-credit college courses, particularly in their junior or senior years. NHBA encourages such enrollment by homeschool students, and the definition above shall not be construed to mean that such students are not homeschooled if the participating college admitted the student as a homeschool high student.

I/We verify that the player listed above is/has…

____a. A homeschool student under the definition of homeschooling above.

____b. At least 13 years old and less than 19 years old on the date of 1 September prior to the season.

____c. Grade 8 or higher as declared by parents.

____d. Played at the high school level for no more than 5 years.

____e. Not been expelled from a public school or private school during the academic school year (current or year prior).

____f. In good academic standing and completing course work as prescribed by parents.

____g. In good standing in regards to character and behavior according to the player’s parents and coaches.

Does player meet homeschool requirements as defined above? Yes / No Please explain any deviations from the definitions above: ___________________________________________________________________

I/We the undersigned have legal custody of the player named above, a minor, and have given our consent for him to participate in events being organized by the St. Louis Patriots Homeschool baseball team. I/We understand that there are inherent risks involved in any athletic event and hereby release the St. Louis Patriots baseball team, its coaches, parents, volunteers, from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my /our child/s involvement.

Parent/guardian name: (print):__________________________________

Parent/guardian signature: _____________________________________

Date:____________