Davenport Southeast Little League 2017 Registration Packet

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1 Davenport Southeast Little League 2017 Registration Packet What: 2016 Davenport Southeast Little League Registration Player Divisions: Fee Rookie League: age 4-6 $65 Competitive Coach Pitch: age 6-8 $90 Minor League: age 8 10 (player pitch) $125 (includes 11 year-olds not selected for Majors) Major League: age $125 Additional Siblings $65 Included in registration fee: Majors(shirt, hat, socks & belt); Minors & CCP(shirt, hat, socks); Rookies(shirt & hat) Here s What You Need to Register: 1. Registration Form (in this packet) 2. Medical Release Form (in this packet) 3. Concussion Form (in this packet) 4. Copy of Birth Certificate (for first time registration) 5. School Enrollment Form* (in this packet) 6. Volunteer Form (in this packet) 7. Registration Fee (cash, check, money order, MC, Visa or Debit Cards) *School Enrollment Form is only needed if you do not reside in SELL Boundaries but the school that your child attends is within the SELL Boundaries All these forms can either be found in this packet or at under the Registration page. Here s How to Register: You have 3 ways to register. 1. Online at 2. Mail forms and payment to: Davenport Southeast Little League % Chris Judge - Treasurer 2926 E. 35 th Street Davenport, IA In person at Modern Woodmen Park: Saturday, February 18 th from 9:00 a.m. 2:00 p.m. Print this packet and complete the registration, medical release, concussion and volunteer forms. For first time registration, print and complete the School Enrollment Form and make a copy of your child s birth certificate. Bring the completed forms and payment with you on February 18th to Modern Woodmen Park between 9:00 a.m. and 2:00 p.m. or mail to the address listed above. If you have any questions regarding registration, please contact Thomas Mason IV, President at or Andrea Willems, Player Agent at

2017 Davenport Southeast Little League Baseball Registration Form Player: FIR: LA: ADDRESS: BIRTHDATE: BOY: GIRL: CITY: ATE: ZIP: PHONE: SCHOOL: NAME/AGE OF SIBLING IN LEAGUE: CHILD WILL TRYOUT FOR

2 2017 Davenport Southeast Little League Baseball Registration Form Player: FIR: LA: ADDRESS: BIRTHDATE: BOY: GIRL: CITY: ATE: ZIP: PHONE: SCHOOL: NAME/AGE OF SIBLING IN LEAGUE: CHILD WILL TRYOUT FOR (PLEASE CIRCLE): ROOKIES CCP MINORS MAJORS RETURNING PLAYER: Y N PARENT/GUAIAN 1: ALL INFORMATION MU BE FILLED OUT FIR: LA: OCCUPATION: PHONE: WK PH: CELL PH: VOLUNTEER(Please check all that apply): Manager Coach Dugout Fields Concessions PARENT/GUAIAN 2: ALL INFORMATION MU BE FILLED OUT FIR: LA: OCCUPATION: PHONE: WK PH: CELL PH: VOLUNTEER(Please check all that apply): Manager Coach Dugout Fields Concessions 1) I/We, the parents/guardians of the above named Player, hereby give my/our approval to participate in any and all Little League activities, including transportation to and from the activities. 2) I/We know that participation in baseball or softball may result in serious injuries and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnify and agree to hold harmless the local Little League, Little League Baseball, Incorporated, the organizers, sponsors, supervisors, participants and persons transporting my/our child to and from activities for any claim arising out of any injury to my/our child whether the result of negligence or for any other cause. 3) I/We agree to return upon request the uniform and other equipment issued to my/our child in as good of condition as when received except for normal wear and tear. 4) I/We agree that our child (candidate) may be required to try out for a team. If such candidate does not attend at least 50% of the tryouts, local Board of Directors approval is required for such candidate to be placed on a team. 5) I/We understand that our child may be chosen at any time to play on a Major Division team, if he or she is of the correct age for such division as determined by the local league and Little League Baseball. Declining to move up to such Major Division team will result in forfeiture of eligibility for the Major Division for the current season, and may be subject to further restrictions by the Local League. 6) I/We will furnish a certified birth certificate of the above-named candidate to League Officials for inspection at registration. 7) Little League Baseball does not limit participation in its activities on the basis of disability, race, color, creed, national origin, gender or religious preference. 8) I/We, the parents/guardians of the above named Player, hereby give my/our approval to have the picture and names published in all Little League approved hand outs and league internet websites. 9)No Player will be excluded due to Financial Hardship. PARENT/GUAIAN SIGNATURE: DATE: OFFICIAL LEAGUE USE: DIVISION: PLEASE CIRCLE ROOKIES CCP MINORS MAJORS DUE PAID Shirt Size(Please circle one): YXS YS YM YL YXL AS AM AL AXL REGIRATION FEE: MAJORS $125, MINORS $125, CCP $90 & ROOKIES $65 ADDITIONAL SIBLINGS $65 $ $ BIRTH CERTIFICATE MEDICAL CONCUSSION VOLUNTEER SCHOOL TOTAL $ $

Little League Baseball and Softball M E D I C A L R E L E A S E NOTE: To be carried by any Regular Season or Tournament Team Manager together with team roster or International Tournament affidavit.

Phone: PARENT OR LEGAL GUAIAN AUTHORIZATION: Email: In case of emergency, if family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel. (i.e. EMT, First Responder, E.

: League/Group ID#: If parent(s)/legal guardian cannot be reached in case of emergency, contact: Name Phone Relationship to Player Name Phone Relationship to Player Please list any allergies/medical

3 Little League Baseball and Softball M E D I C A L R E L E A S E NOTE: To be carried by any Regular Season or Tournament Team Manager together with team roster or International Tournament affidavit. Player: Date of Birth: Gender (M/F): Parent (s)/guardian Name: Parent (s)/guardian Name: Relationship:_ Relationship:_ Player s Address: City: State/Country: Zip: Home Phone: Work Phone: Mobile Phone: PARENT OR LEGAL GUAIAN AUTHORIZATION: In case of emergency, if family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel. (i.e. EMT, First Responder, E.R. Physician) Family Physician: Phone: Address: City: State/Country: Hospital Preference: Parent Insurance Co: Policy No.: Group ID#: League Insurance Co: Policy No.: League/Group ID#: If parent(s)/legal guardian cannot be reached in case of emergency, contact: Name Phone Relationship to Player Name Phone Relationship to Player Please list any allergies/medical problems, including those requiring maintenance medication. (i.e. Diabetic, Asthma, Seizure Disorder) Medical Diagnosis Medication Dosage Frequency of Dosage Date of last Tetanus Toxoid Booster: The purpose of the above listed information is to ensure that medical personnel have details of any medical problem which may interfere with or alter treatment. Mr./Mrs./Ms. Authorized Parent/Guardian Signature Date: FOR LEAGUE USE ONLY: League Name: League ID: Division: Team: Date: WARNING: PROTECTIVE EQUIPMENT CANNOT PREVENT ALL INJURIES A PLAYER MIGHT RECEIVE WHILE PARTICIPATING IN BASEBALL/SOFTBALL. Little League does not limit participation in its activities on the basis of disability, race, color, creed, national origin, gender, sexual preference or religious preference.

4 A FACT SHEET FOR PARENTS AND UDENTS HEADS UP: Concussion in High School Sports The Iowa Legislature passed a new law, effective July 1, 2011, regarding students in grades 7 12 who participate in extracurricular interscholastic activities. Please note this important information from Iowa Code Section C, Brain Injury Policies: (1) A child must be immediately removed from participation (practice or competition) if his/her coach or a contest offi cial observes signs, symptoms, or behaviors consistent with a concussion or brain injury in an extracurricular interscholastic activity. (2) A child may not participate again until a licensed health care provider trained in the evaluation and management of concussions and other brain injuries has evaluated him/her and the student has received written clearance from that person to return to participation. (3) Key defi nitions: Licensed health care provider means a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, physical therapist, or athletic trainer licensed by a board. Extracurricular interscholastic activity means any extracurricular interscholastic activity, contest, or practice, including sports, dance, or cheerleading. What is a concussion? A concussion is a brain injury. Concussions are caused by a bump, blow, or jolt to the head or body. Even a ding, getting your bell rung, or what seems to be a mild bump or blow to the head can be serious. What parents/guardians should do if they think their child has a concussion? 1. OBEY THE NEW LAW. a. Keep your child out of participation until s/he is cleared to return by a licensed healthcare provider. b. Seek medical attention right away. 2. Teach your child that it s not smart to play with a concussion. 3. Tell all of your child s coaches and the student s school nurse about ANY concussion. What are the signs and symptoms of a concussion? You cannot see a concussion. Signs and symptoms of concussion can show up right after the injury or may not appear or be noticed until days after the injury. If your teen reports one or more symptoms of concussion listed below, or if you notice the symptoms yourself, keep your teen out of play and seek medical attention right away. UDENTS: If you think you have a concussion: Tell your coaches & parents Never ignore a bump or blow to the head, even if you feel fi ne. Also, tell your coach if you think one of your teammates might have a concussion. Get a medical check-up A physician or other licensed health care provider can tell you if you have a concussion, and when it is OK to return to play. Give yourself time to heal If you have a concussion, your brain needs time to heal. While your brain is healing, you are much more likely to have another concussion. It is important to rest and not return to play until you get the OK from your health care professional. IT S BETTER TO MISS ONE CONTE THAN THE WHOLE SEASON. Signs Reported by Students: Headache or pressure in head Nausea or vomiting Balance problems or dizziness Double or blurry vision Sensitivity to light or noise Feeling sluggish, hazy, foggy, or groggy Concentration or memory problems Confusion Just not feeling right or is feeling down PARENTS: How can you help your child prevent a concussion? Every sport is different, but there are steps your children can take to protect themselves from concussion and other injuries. Make sure they wear the right protective equipment for their activity. It should fi t properly, be well maintained, and be worn consistently and correctly. Ensure that they follow their coaches rules for safety and the rules of the sport. Encourage them to practice good sportsmanship at all times. Signs Observed by Parents or Guardians: Appears dazed or stunned Is confused about assignment or position Forgets an instruction Is unsure of game, score, or opponent Moves clumsily Answers questions slowly Loses consciousness (even briefl y) Shows mood, behavior, or personality changes Can t recall events prior to hit or fall Can t recall events after hit or fall Information on concussions provided by the Centers for Disease Control and Prevention. For more information visit: IMPORTANT: Students participating in interscholastic athletics, cheerleading and dance; and their parents/guardians; must annually sign the acknowledgement below and return it to their school. Students cannot practice or compete in those activities until this form is signed and returned. We have received the information provided on the concussion fact sheet titled, HEADS UP: Concussion in High School Sports. Student s Signature Date Student s Printed Name Parent s/guardian s Signature Date Student s Grade Student s School May2012-CE

5 Little League Baseball and Softball School Enrollment Form The District and the local league will maintain this form and supporting documentation in their files. Completion of this form is only required ONCE during a participant s career, unless the school enrollment changes. A II(d) would then be required. To Be Filled Out By Parent/Legal Guardian Date: League Name: Player/Student Name: League ID#: Date of Birth: Division: Baseball Level: Tee Ball LL (Majors) Junior (Check One) Softball (Check One) Minors Intermediate Senior Parent/Guardian Address: (Street) (City/State) (Zip) (Print Name of Parent/Legal Guardian) (Signature of Parent/Legal Guardian) (Date) To be filled out by School Administrator, Principal, or Vice Principal I, of School, located at (Print Name) ;. hereby verify that has enrolled and is attending the above named school for the (Print Student Name) (Physical Address) academic year prior to October 1st, of the current academic year. This student has been enrolled as of (Date) (Print School Name) (School Phone Number) (Year) (Signature) (Date) Title (School Administrator, Principal, or Vice Principal) If the Charter/Tournament Committee subsequently finds that the information submitted as acceptable documentation regarding school enrollment/attendance now shows that the previously submitted information/documentation was falsified, misrepresented or insufficient, then Little League Baseball, Incorporated reserves the right to impose sanctions and/or penalties on all appropriate parties, including but not limited to players, coaches, league officials, and/or the league which could result in suspension and/or terminations with Little League Baseball, Incorporated. Last Updated: 11/14/2016

Little League Volunteer Application - 2017 Do not use forms from past years. Use extra paper to complete if additional space is required.

6 Little League Volunteer Application Do not use forms from past years. Use extra paper to complete if additional space is required. A COPY OF VALID GOVERNMENT ISSUED PHOTO IDENTIFICATION MU BE ATTACHED TO COMPLETE THIS APPLICATION. Name Date Address City State Zip Social Security # (mandatory with First Advantage ) Cell Phone Business Phone Home Phone: Address: Date of Birth Occupation Employer Address Special professional training, skills, hobbies: Community affiliations (Clubs, Service Organizations, etc.): Previous volunteer experience (including baseball/softball and year): Do you have children in the program? Yes No If yes, list full name and what level? Special Certification (CPR, Medical, etc.): Do you have a valid driver s license: Yes No Driver s License#: State Have you ever been convicted of or plead guilty to any crime(s) involving or against a minor?: Yes No If yes, describe each in full: Are there any criminal charges pending against you regarding any crime(s) involving or against a minor? Yes No If yes, describe each in full: Have you ever been refused participation in any other youth programs? Yes If yes, explain: In which of the following would you like to participate? (Check one or more.) League Official Coach Umpire Field Maintenance Manager Scorekeeper Concession Stand Other No Please list three references, at least one of which has knowledge of your participation as a volunteer in a youth program: Name/Phone IF YOU LIVE IN A ATE THAT REQUIRES A SEPARATE BACKGROUND CHECK BY LAW, PLEASE ATTACH A COPY OF THAT ATE S BACKGROUND CHECK. FOR MORE INFORMATION ON ATE LAWS, VISIT OUR WEBSITE: AS A CONDITION OF VOLUNTEERING, I give permission for the Little League organization to conduct background check(s) on me now and as long as I continue to be active with the organization, which may include a review of sex offender registries (some of which contain name only searches which may result in a report being generated that may or may not be me), child abuse and criminal history records. I understand that, if appointed, my position is conditional upon the league receiving no inappropriate information on my background. I hereby release and agree to hold harmless from liability the local Little League, Little League Baseball, Incorporated, the officers, employees and volunteers thereof, or any other person or organization that may provide such information. I also understand that, regardless of previous appointments, Little League is not obligated to appoint me to a volunteer position. If appointed, I understand that, prior to the expiration of my term, I am subject to suspension by the President and removal by the Board of Directors for violation of Little League policies or principles. Applicant Signature Date If Minor/Parent Signature Date Applicant Name(please print or type) NOTE: The local Little League and Little League Baseball, Incorporated will not discriminate against any person on the basis of race, creed, color, national origin, marital status, gender, sexual orientation or disability. LOCAL LEAGUE USE ONLY: Background check completed by league officer on System)s) used for background check (minimum of one must be checked): Regulation I(c)(9) Mandates First Advantage or another provider that is comparable *First Advantage Sex Offender Registry Data along with a National Criminal Records check of at least 281 million records *Please be advised that if you use First Advantage and there is a name match in the few states where only name match searches can be performed you should notify volunteers that they will receive a letter directly from LexisNexis in compliance with the Fair Credit Reporting Act containing information regarding all the criminal records associated with the name, which may not necessarily be the league volunteer. Only attach to this application copies of background check reports that reveal convictions of this application.

7 Frequently Asked Questions (FAQ) Q: How is Davenport Southeast Little League structured? A: The league is divided into four divisions Majors, Minors, CCP and Rookies. Q: How is it determined which division they will play in? A: Age is the primary determinant, but a tryout and draft process is in place that creates variability based on skill level. In general: Majors: Ages Minors: Ages 8-10 (Player Pitch and includes some 11 year old players not selected for Majors) CCP: Ages 5-8(Competitive Coach Pitch using Coach as pitcher but playing modified baseball rules to get players ready for Minors which is player pitch. Scores/Standings are kept and begins competitive play) Rookies: Ages 4 6 (Starts out as coach pitch with tee rescue. Emphasis is on introduction to baseball and basic skills development. No scores or standings are kept) Q: Can I request my 10 or 11 year-old play in the Minors or Majors? A: Yes. Q: Does my child have to try out? A: Tryouts are MANDATORY for Majors, Minors and CCP players. Rookies players will be assigned to their teams. There are two different dates available to accommodate schedule conflicts. See the information on tryouts. Q: How is it determined which team my child plays on? A: Teams are selected through the draft process. After tryouts, the coaches draft their team. The Majors hold their draft first, followed by Minors and CCP. The remaining players, ages 6 and under, for Rookies will be divided evenly with the goal of having kids per team. Q: What will my child need above and beyond what the league provides? A: In Majors, Minors and CCP, each player should have the following: Gray baseball pants (required) Glove (required) Protective cup (required to play catcher, strongly encouraged for all) Cleats, non metal (recommended)

Q: If I want to buy my child their own bat, what is recommended? A: The bat must be a Little League approved metal bat. The sizes we recommend depend largely upon the size of the child.

8 Q: If I want to buy my child their own bat, what is recommended? A: The bat must be a Little League approved metal bat. The sizes we recommend depend largely upon the size of the child. Traditionally, Minor League players use bats weighing oz. and are about 28 long. Major League players typically use bats weighing oz. and are about 30 long. This is only a guideline. Please refer to the SELL website for approved Official Little League Bats List. Q: Are there any special requirements if I want to help at practices or be an assistant coach? A: Yes. Little League requires that a background check be performed. If you are interested in volunteering, please complete a Volunteer Application Form and provide a copy of your photo ID. Upon us receiving word of your clearance, you may begin helping the team. Q: Where and when are the games played? A: Most league games are played at Prairie Heights Park. There are three lighted fields at Prairie Heights Park for all divisions to use. Majors and Minors will play interleague games with other Davenport Leagues and will play some games at other fields in the QC. Q: How long does the season last? A: The Majors, Minors & CCP season runs about 9-11 weeks. The Rookie season runs about 5-6 weeks. Practices will begin prior to the start of the season. Your child s manager will be in contact with you to provide schedule details.

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Join us for the 2017 Little League Baseball Season at Prairie Heights Park!

Join us for the 2017 Little League Baseball Season at Prairie Heights Park! Dear PV School District Parent/Guardian, You are receiving this letter because you reside within the boundaries of Southeast Little League and your child is eligible to participate in the 'Best' Little