Registration | Firebirds

Firebirds Registration

First name

Last name

Team

Multi-line address

Country/Region

Address

City

Zip / Postal code

Date of Birth

Month

Day

Year

Player Grade (This coming School Year)

Player School Name

Player's Expected High School (if not yet in high school)

Player Email

Player Phone

Parent/Caregiver 1 First Name

Parent/Caregiver 1 Last Name

Parent/Caregiver 1 Email

Parent/Caregiver 1 Phone

Parent/Caregiver 1 Alternate Phone

Parent/Caregiver 2 First Name

Parent/Caregiver 2 Last Name

Parent/Caregiver 2 Email

Parent/Caregiver 2 Phone

Parent/Caregiver 2 Alternate Phone

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Relationship

Emergency Contact Phone

Emergency Contact Alternate Phone

Per Fairfax County field allocation policies, registration information for each participant is provided to the Fairfax County Department of Neighborhood and Community Services (NCS). Once NCS receives this information, it becomes public record and as such may be released under the Virginia Freedom of Information Act (FOIA) unless the parent/guardian specifically requests that this information not be released. Please check here if you do not grant NCS permission to release your child's registration information.

I do not grant NCS permission to release my child's registration information.

Assumption of Risk Agreement:

On behalf of myself and my child, in consideration of being allowed to participate on behalf of the Northern Virginia Girls Softball Association/Firebirds (NVGSA) athletic program and related events and activities, I acknowledge and agree that:

1. Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and

2. I knowingly and freely assume all such risks, both known and unknown. I understand that neither I nor NVGSA can control the actions and behaviors of others, and the behaviors of others directly affect the level of risk. I assume full responsibility for my participation; and

3. I willingly agree to comply with the requirements identified in the Firebirds Return to Play Policy, and recognize that if I comply with the recommended actions in the policy, I will help to further reduce the level of risk. If I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest official immediately.

Social Media Release:

The releasor grants permission to Firebirds Fastpitch to use player’s image/likeness in photographs, audio recordings and/or video recordings on the Firebirds’ website and social media accounts to include but not limited to Facebook, Instagram, Tik Tok and X, without recognition or acknowledgement given to the releasor.
The releasor understands that they will not receive any monetary compensation from Firebirds for the permissions granted herein and hereby waives any rights of inspection or approval of the photos/recordings prior to Firebirds posting on their social media accounts and website.
In giving this consent, the releasor releases Firebirds from liability for any violation of any personal or proprietary right the releasor may have in connection with all third parties’ use of the images on social media.
The releasor grants Firebirds creative permission to alter the photographs/videos/recordings provided that they are not altered in any explicit manner or used to maliciously represent the releasor and associates.
The releasor certifies that they are 18 years of age or older. If the releasor is under that age of 18, their parent or guardian must sign this release.

I agree to the Assumption of Risk Agreement/Social Media Release.