Spring Minor League (1st-3rd Grade)
Please complete all the fields in the form below. The information collected on this form will be used by the West Georgia Kickball League for the formation of teams and for contact purposes only. The cost of the league is $100 This will include a headband, 2 wristbands, practice day, 7 games, souvenir coin, kickball and coach. After you have completed the form and click submit you will be redirected to the payment link. Thanks!
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Parent Email: *
This is where updates, schedules and all Kickball information will be sent.
Player's Name (First & Last) *
Player's School *
Player's Grade *
Player's Birth Date *
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Player's Gender *
Please Rate your child's kickball ability: 1-5 (This will be used to help create teams) *
Optional: list the child's name that you would like for your child to be on the same team.  
We cannot guarantee that all players will be paired with each request, but we will strive to meet everyone's requests.
Parent Name/ Emergency Contact *
Parent Cell Phone Number *
Sportsmanship *
**Please reference sportsmanship policy on the website westgakickball.com 
Required
Does your child have any physical restrictions? *
Food allergies, ant bites, physical ailments, etc..
West Georgia Kickball League has my permission to use my or my child's photograph publicly to promote West Georgia Kickball. I understand the images may be used in print publications, presentations, websites, and social media. I also understand that no royalty, fee or other compensation shall become payable to me by reason of such use. *
WEST GEORGIA KICKBALL LEAGUE IN PARTNERSHIP WITH THE VILLA RICA/ DOUGLAS COUNTY PARKS AND RECREATION WAIVER AND RELEASE OF LIABILITY FORM. READ BEFORE COMPLETING REGISTRATION.In consideration of being allowed to participate in any way in the West Georgia Kickball League in partnership with The Villa Rica/ Douglas County Parks and Recreation and any related events and activities, the participant acknowledges, appreciates, and agrees that: 1) The risk of injury from the activities involved in this program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce this risk, the risk of serious injury does exist; and, 2) I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, 3) I willingly agree to comply with the stated and customary terms and conditions for participation. If, however, I observe any unusual significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately; and, 4) I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS the West Georgia Kickball League and The Villa Rica/ Douglas County Parks and Recreation, their officers, officials, agents, and/or employees, other participants, volunteers, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the pre-game, recreation, play, or post-game events (“RELEASEES”), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE, to the fullest extent permitted by law in correction with (A) my participation in the sport of kickball, or (B) my attendance at any social event or gathering that may be organized, authorized, or paid for by the RELEASEES, individual kickball players, or any league or division organized under the RELEASEES or their rules, including but not limited to any functions, and any pre-game or post-game events or gatherings. 5) I, hereby consent to the use by the West Georgia Kickball League and The Villa Rica/ Douglas County Parks and Recreation including its agents, assigns and licensees of my name, photo, likeness or film, videotape and/or sound recording of me (collectively, hereinafter referred to as “Information”) to promote or publicize business both internally and externally. I hereby release WGKL/VRPR/DCPR from any and all liability for using the Information and waive all claims and cause of action against WGKL/VRPR/DCPR arising from the use of the Information. I also hereby grant perpetual and irrevocable license to Villa Rica/ Douglas County Parks and Recreation to use the Information in any manner, including, but not limited to, reproduction, sale, exhibition, copying, broadcast, and distribution of the Information or any program incorporating the Information it deems appropriate to promote its business and understand that the Information may be edited or combined with other images, sound, text or information. I expressly disclaim all rights to all values and benefits Villa Rica/ Douglas County Parks and Recreation may gain through the use of the Information. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS FOR THE OPPORTUNITY TO PARTICIPATE IN KICKBALL. I AGREE TO THE ALL THE TERMS OF THIS WAIVER BY CHECKING THE BOX AT CHECKOUT TO COMPLETE THE REGISTRATION. *
Required
I understand that once I submit this form I must click the payment link provided and pay before registration is complete.   *
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