Registration

NCOA Baseball Registration Form 2009

Date: -- mm/dd/yy

Contact information:

First Name: Last Name

Address:

City: State: Zip Code:

Work Phone: Home Phone: Cell Phone:

E-mail:

Birth date: -- dd/mm/yy

Have you ever been convicted of a crime for which you are required to register with the
local law enforcement agency? Yes No

Have you ever been convicted of a felony? Yes No
If Yes, explain:

Have you signed up and paid dues for another NCOA sport group during the 2008-2009 school year? Yes No

Dues received on or before February 1, 2009 are $50.00. Dues received on February 2, 2009 or after are $60.00. After submitting this registration form, you should mail your check to NCOA c/o Tom Murphy at 491 Wyndgate Road, Sacramento, CA 95864. Your check needs to be received prior to February 1, 2009, to qualify for the early discount registration. Make sure your name or the name of the official signing up is on your check. Your received check will be matched up to the Submitted registration list.

If you have already paid dues to another sport for this 2008-2009 scholastic year (football, volleyball, water polo, basketball), then your dues for basketball will be $30.00 if received on or before February 1, 2009, and $40.00 if received on or after February 2, 2009.

Number of years with NCOA Baseball:

If new, who referred you to NCOA Baseball?

What type of work do you do, what profession are you in?

Please list some of your hobbies?

Please list any special skills you have.

What levels of baseball have you worked? Little League High School College Other

Total years of experience at all levels?

Please tell us about your past and present program/district affiliations.
Also include any volunteer work, youth programs, league name, with chief umpire if known, and summer associations.

By submitting this form you acknowledge that:

You are a member of NCOA, not an employee of NCOA. As a member, you are an independent contractor per Section 3352 Subsection (u) of the labor code. As such:

	Payroll withholding such as taxes and contributions are not taken out your game fees
	The IRS has specific regulations concerning this type of income and how to report it. Make certain that you comply with the IRS reporting requirements
	You are not eligible for worker's compensation or other employment benefits as an independent contractor when accepting assignments from NCOA and/or it assignor. I agree

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