FUMC-Baseball Registration 2017
Please fill out one per child. Please complete by February 4, 2017. Questions: Call Chris Bercher at 479-806-7028 or the church office at 479-782-5068.
Childs' Name
Your answer
Age
Must be age 4 by August 1, 2017 or NOT be age 16 before May 1, 2017
Your answer
Date of Birth
Your answer
Street Address
Your answer
City
Your answer
State
Your answer
Zip Code
Your answer
Telephone
Your answer
Mom's Name
First and Last
Your answer
Mom's E-mail Address
Your answer
Mom's Cell Phone Number
Your answer
Dad's Name
First and Last
Your answer
Dad's Email Address
Your answer
Dad's Cell Phone Number
Your answer
Emergency Contact (besides parents):
Name and Phone Number
Your answer
Has your child played on a FUMC baseball team in the past?
If you answer yes, please list the coach's name on next question.
Coach's Name
If you answered yes above, please answer below.
Your answer
Are you a member of First United Methodist Church, Fort Smith, AR?
Are you currently a member of another church in the area?
If you answer yes, please list the church's name in the next question.
Church's Name
If you answered yes above, please list the Church's name below.
Your answer
Does your child play baseball for any other organization (travel ball)?
If you answer yes, please list the organization/team in question below.
Organization/team
If you answered yes above, please list the organization team below
Your answer
Dad, would you be interested in being a team parent or coach?
Mom, would you be interested in being a team parent or coach?
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