Name *

First Name

Last Name

Phone *

(###)

###

####

Date of Birth *

MM

DD

YYYY

I'm under the age of 18

Yes

No

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact Name *

First Name

Last Name

Emergency Phone Number *

(###)

###

####

Check Areas of Interest *

You can select more than one option.

Coach

Assistant Coach

Umpire

Player Buddy

Parent Helper

Game Announcer/Scorekeeper

Canteen Worker

Other

Do you have any valid First Aid certification? *

Yes

No

Release of Liability *

I hereby release and agree to indemnify and hold harmless the Miracle League of Ottawa, their officers, directors, organizers, sponsors, agents, insurers, supervisors, participants, volunteers and the City of Ottawa from any and all claims for personal injury, death, property damage, or any type of claim or damage, whether the result of negligence or for any other cause (including but not limited to attorney’s fees or litigation expenses) resulting from any volunteer activities with Miracle League baseball. I assume all risks and hazards incidental to volunteering with Miracle League games and activities.

I agree

Background Check *

I understand and agree that the Miracle League of Ottawa may require a background investigation on me before allowing me to participate as a volunteer. This investigation may include, but not necessarily be limited to, review of a criminal history report from the Ottawa Police Service or other law enforcement agency. The Miracle League of Ottawa may refuse to allow my participation for any or no reason in its sole discretion.

I agree

Media Release *

I hereby grant the Miracle League of Ottawa, its affiliates, franchises, advertising and promotional agencies, and their agents, their irrevocable, unrestricted right to use, publish, display and distribute materials bearing my name, voice, likeness or any other identifiable representation of myself. These materials may appear in any form, style, color or medium whatsoever (including, without limitation, photographs, video tapes, films, sound recordings, software, drawings, prints, broadcast, internet and electronic media). I agree that all material containing any identifiable representation of me (including without limitation, all negatives, plates and masters of any photographs, files, prints or tapes) shall be and remain the sole and exclusive property of the Miracle League of Ottawa. I hereby release and forever discharge the Miracle League of Ottawa from any and all liability and damages relating to the use of my name, voice, likeness or any other identifiable representation of me. I hereby waive any right I may have to inspect or approve the finished materials or any part or element thereof that incorporate my name, voice, likeness or any other identifiable representation of myself.

I agree

I disagree