Please make sure you register before the cut-off date 
 
LATE REGISTRATIONS will be accepted for 15 DAYS with a $25.00 late FEE!

Does your child have a medical condition, medications, or allergies that the coach should be aware of?   *



* The  Carroll County Parks & Recreation Department  does not discriminate on basis of race, color, national origin, age, religion, political affliction, handicapping condition, or sex in its recreational programs.  No one shall be denied recreational activity solely because of any impairment, which is unrelated to the ability to engage in activities  in the position of  which application has been made.
 
* Parents/Guardian should be advised that they will be hld financially responsible for the loss, misuse, or neglect of any uniform and equipment issued to their child for participation in the league program.
 
* I assume ALL risk and hazards incidental to such parcipitation.  The Caroll County Parks & Recreation, Carroll County Board of Supervisors, Coaches, and the Carroll County School System will be held blameless in case of an accident or injury.
I, hereby, give permission for myself/my child to be photographed while participating in department activities/programs, and I give this Department permission to use or distribute such photo and identification.  I understaznd this consent complies with Section 8.0 1-40 of the Code of Virginia.  I/We have read the contents of this online form and do hereby agree to the conditions outlined.  I/We hereby, for myself, my heirs, executors, and administrators, waive and release any and all rights and claims for damages I may have against for injuries received through participating in the above-mentioned sport/league.  

I, hereby, give my permission for my son/daughter to participate in the Carroll County Parks & Recreation Sports Program.  

I also, hereby, realize that payment is due  within ten days of this form submission.  Payment is due before child will be allowed to participate.
 
Make checks payable to "Carroll County Parks & Recreation Department".  Checks may be mailed or hand delivered to the Carroll County Parks & Recreation Department, 129 Ballpark Drive, Hillsville, VA 24343.  
 
Click Next button to fill out the REQUIRED "CODE OF CONDUCT" Form!