Registration Fee: Paid $_____ St. Charles Parish TODAYS DATE:____________
Parks and Recreation Department
Parent Shirt Pd:$______ Des Allemands Booster Club
Check #:_______Cash:_____ Registration Form
BIRTH CERTIFICATE List:________ Attached:_________ Mailed:________
SPORT: AGE:
___BASEBALL ___FRANCHISE ___FOOTBALL ___BOY ___5-6
___SOFTBALL (Competitive) ___BASKETBALL ___7-8
___T-BALL ___PARISH ___CHEERLEADING ___GIRL ___9-10
___YEARS PLAYED (Recreation) ___11-12
___13-14
______________________________________________________________________________________
FIRST MIDDLE LAST Name: (As it appears on Birth Certificate)
Birthday:______________ Age:________________ Sex:________________________
Home Address:____________________________________ City:______________________________
Mail Address:_____________________________________ Zip Code:__________________________
Home Phone:__________________ Work:____________________ Emer:______________________
Email:______________________________________
To Whom it may Concern:
I/We grant permission for my/our son/daughter to participate in the sports program of the Booster Club and St. Charles Parish
Parks and Recreation Department.
He/She is in good health and has no physical defects that strenuous physical exercise would affect.
(Note: A notice from a physician should accompany this form if there is any limitation.)
I/We agree to release the Booster Club and the St. Charles Parish Council, St. Charles Parish Parks and Recreation Department, the
Director, Coaches, and Sponsors for any injuries, disabilities, death, loss or damage to person or property including accidents which
he/she may Incur while participating in practice sessions, games, or while traveling to and from any games and activities, whether
arising from the negligence of the release or otherwise, to the fullest extent permitted by law.
I/We do further agree to return all uniforms and equipment issued to my/our son/daughter upon Request of his/her sponsor or
coach. I/We understand that no one in our family will be able to participate in any St. Charles Parish Parks and Recreation
Department Sports Program until the equipment is returned or paid for in full.
I/We also certify that the information concerning my/our son/daughter birth date is correct. I/We understand that any false
information may result in my/our son/daughter being suspended from participating in the St. Charles Parish Parks and Recreation
Program for a period of not less than Two years.
NOTE: Each child is required to have a copy of his/her birth certificate on file with the Recreation Department.
Des Allemands Booster Club
NOTE: LATE FEE FOR AFTER REGISTRATION WILL BE $15.00 (ALSO UNABLE TO GUARANTY UNIFORMS WILL BE IN ON TIME
THERE ALSO WILL BE A $25.00 CHARGE ON ALL NSF CHECKS. NO REFUNDS AFTER REGISTRATION.
At least one parent or guardian signature is required.
Parent/Guardian:_____________________________________________________________________________
Address:____________________________________________________________________________________
Telephone:____________________________________ _______________________________________
Home Work
Volunteer for coaching:_________________________________________________________________
DABC UNIFORM FORM
CHILD’S NAME:________________________________________________________________________
AGE GROUP:_____________________________ MALE:_______________ FEMALE:_________________
T – SHIRT SIZE:_________PANT SIZE:__________SHORT SIZE:__________ PARENT SHIRT SIZE:________
(boys) (T-ball and girls)