City of Delaware Summer
Youth Baseball Registration Form
REGISTRATION: FEBRUARY 8 through MARCH 6, 2021
On-line registration and payment are available. Families wishing to register on-line can fill out the registration
below, e-mail it to pwcs@delawareohio.net and phone in payment information to City of Delaware Customer
Service at 740-203-1810. Registration and payment can also be filled out at home and, with payment, placed in
either red drop-off box located at Mingo Park, 500 East Lincoln Avenue, or at City Hall, 1 S. Sandusky Street.
PLEASE PRINT AND FILL OUT COMPLETELY
Participant’s Name: Date of Birth: Male Female (please check one)
Address: City: Zip:
Home Phone: Emergency Phone: Cell Phone:__________________________________
List allergies or other medical conditions that we should be aware of:
Age as of May 1, 2021: Shirt Size: Y 7/8 Y10/12 Y14/16 AS AM AL AXL
Delaware City Resident: Yes No Place of Employment:
(If living outside of the Delaware City Limits)
Please Circle Appropriate League - All Ages Are as of May 1, 2021
Coach Pitch PONY BASEBALL
Ages: 5-6 Ages: 13-15
Cost: Resident Rate: $40.00 Cost: Resident Rate: $45.00
Non-Resident Rate: $55.00 Non-Resident Rate: $60.00
Pinto
Ages: 7-8
Cost: Resident Rate: $40.00
Non-Resident Rate: $55.00
MUSTANG BASEBALL
Ages: 9-10
Cost: Resident Rate: $40.00
Non-Resident Rate: $55.00
LITTLE LEAGUE BASEBALL
Ages: 11-12
Cost: Resident Rate: $45.00
Non-Resident Rate: $60.00
Please write your name in the space below if you are able/willing to volunteer or assist in the following:
Head Coaching Assistant Coaching Umpiring Sponsoring a Team
CONSENT TO USE PHOTOGRAPHS: I understand that photographs may be taken of me and/or my child at any recreation program or facility for publication in material used
to promote department programs, classes, or events.
RELEASE OF ALL CLAIMS and PROMISE NOT TO SUE: I/we the parent/guardian of the above child, release the City of Delaware, their employees, agents, officers and
servants of any risks and hazards incidental to the above activity; and hereby forever release, waive and relinquish the Delaware Department of Recreation Services and the City of
Delaware, its instructors and supervisors and all other persons assisting in the conduct of said activities to the participant. I/we understand that because of prohibitive costs, no
accidental, health or life insurance covering the participants in this program will be procured and that my/our consent to the participation of the above-named participant in this
program is made with this understanding.
Parent/Guardian (PRINT): E-Mail:
Parent/Guardian: Please check box as proof of consent Date:
Make Checks Payable To: City of Delaware. A $15 service fee will be charged for a returned check
For additional information call (740) 203-1455
For Office Use Only:
Date Received: Amount Received: Cash/Ck/MO/CC: Staff Initials: Residency Checked:
Important 2021 Dates
Registration Deadline: March 6
Practice Dates: TBD
Games Begin: TBD
