ROC-N-ART – Recreation Outreach Center

Women's Only Fitness Center Orientation

Name*
First Last
Email*
Phone*
Registration Fee
Price: $5.00
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REOPENING LETTER

Dear ROC patrons,

First of all, let me thank you for your continued faithfulness and diligence as we walk through the COVID pandemic. Our current guidelines are listed below.

Masks will be required at all times while inside the ROC, even when working out.
Group Fitness classes have resumed at 33% capacity.
All birthday parties have been canceled until January 10^th.

We will operate at a 33% capacity in all of the ROC spaces. Please know that the health and well being of all of our ROC patrons is at the heart of following the mandates of our Governor. We will continue to keep you informed as to any changes or updates to our ROC policies.

If we can help you in any way, please let me know.

Sharlena Maney

Director of Recreation Outreach

The ROC at Immanuel Baptist Church

Biggest Loser Sign Up

Name*
First Last
Email*
Phone*
Birthday*
Date Format: MM slash DD slash YYYY
T-shirt Size*
Payment Information
Member*
- ROC Member
- ROC Non-Member
Total
$0.00
Credit Card

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2020 HS Boys Bball Camp

2020 ROCSPORTS High School BOYS Basketball
Registration: November 1st - December 5th The ROC (@ Immanuel Baptist Church) $75 per person (price increases to $85 after November 27th)
Player Name*
First Last
Player Email*
Player Phone*
Player Birthday*
Date Format: MM slash DD slash YYYY
Current Grade
Years Played*
Player's Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
T-Shirt Size*
Church (if you regularly attend, which one?)
Player Notes (any information we should know?)
Would you like to coach your son's team?*
If yes, please write your name here
Father/Guardian Name*
Father/Guardian Phone Number*
Mother/Guardian*
Mother/Guardian Phone Number*
Does this participant have: any disabilities, present injuries, limitations, allergies, hemophilia, heart condition, history of respiratory illness or any other significant condition?*
If yes, please state the condition*
If you wish to have your family doctor contacted in case of emergency, what is his/her name?*
Family doctor phone number:*
EMERGENCY AUTHORIZATION
I, the undersigned parent or legal guardian of the participant, a minor, hereby authorize the coaches, assistant coaches or parents of the players acting in the capacity of activity supervisors/vehicle drivers, as my Agents, to consent to medical, surgical or dental examination and/or treatment. In case of emergency, I hereby **
- Authorize - Emergency
Parent/Guardian Name*
First Last
Parent/Guardian phone number*
Parent/Guardian Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Waiver of Liability and Disclaimer and Contract for Permission to Photograph
I, the parent of guardian of the above named individual, acknowledge that participation in athletic events necessarily involves risk of physical injury. I further acknowledge that the programs of the ROCSPORTS Basketball League and Immanuel Baptist are primarily administered by parents who volunteer their time rather than paid professionals. In consideration for accepting the registration of the above name individual and permitting the voluntary participation if said individuals in its program, I hereby release, discharge, and hold harmless the ROCSPORTS Basketball League, its employees, Immanuel Baptist, volunteers and other representatives from any claims arising out of relation to any physical injury that may result to said individual while participating in the ROCSPORTS Basketball League sponsored event, including any physical negligence of an official, referee or coach while performing his/her duties during any practices, games or camps. I hereby grant permission to the ROC, a department of Immanuel Baptist Church, to use my photograph for the ROCSPORTS Basketball League.*
- Authorize - Waiver of Liability
Price*
Price: $85.00
This price will cover the league fees and a reversible jersey.
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American Express
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Card Number Expiration Date Security Code Cardholder Name

2020 ROCSPORTS Basketball Camp

2020 ROCSPORTS Basketball Camp
July 27th-31st, 2020 The ROC (@ Immanuel Baptist Church) $65 per person includes t-shirt
Player Name*
First Last
Player Email*
Player Phone*
Player Birthday*
Date Format: MM slash DD slash YYYY
Recent Grade COMPLETED*
Years Played*
Player's Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
T-Shirt Size*
Church (if you regularly attend, which one?)
Player Notes (any information we should know?)
Would you like to coach your child's team?*
If yes, please write your name here
Father/Guardian Name*
Father/Guardian Phone Number*
Mother/Guardian*
Mother/Guardian Phone Number*
Does this participant have: any disabilities, present injuries, limitations, allergies, hemophilia, heart condition, history of respiratory illness or any other significant condition?*
If yes, please state the condition*
If you wish to have your family doctor contacted in case of emergency, what is his/her name?*
Family doctor phone number:*
EMERGENCY AUTHORIZATION
I, the undersigned parent or legal guardian of the participant, a minor, hereby authorize the coaches, assistant coaches or parents of the players acting in the capacity of activity supervisors/vehicle drivers, as my Agents, to consent to medical, surgical or dental examination and/or treatment. In case of emergency, I hereby **
- Authorize - Emergency
Parent/Guardian Name*
First Last
Parent/Guardian phone number*
Parent/Guardian Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Waiver of Liability and Disclaimer and Contract for Permission to Photograph
I, the parent of guardian of the above named individual, acknowledge that participation in athletic events necessarily involves risk of physical injury. I further acknowledge that the programs of the ROCSPORTS Basketball League and Immanuel Baptist are primarily administered by parents who volunteer their time rather than paid professionals. In consideration for accepting the registration of the above name individual and permitting the voluntary participation if said individuals in its program, I hereby release, discharge, and hold harmless the ROCSPORTS Basketball League, its employees, Immanuel Baptist, volunteers and other representatives from any claims arising out of relation to any physical injury that may result to said individual while participating in the ROCSPORTS Basketball League sponsored event, including any physical negligence of an official, referee or coach while performing his/her duties during any practices, games or camps. I hereby grant permission to the ROC, a department of Immanuel Baptist Church, to use my photograph for the ROCSPORTS Basketball League.*
- Authorize - Waiver of Liability
Price*
Price: $65.00
This price will cover the league fees and a t-shirt.
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Weight Loss for Life

Name*
Email*
Phone Number*
Pick a Design*
Product Name
Price: $30.00
Total
$0.00
Credit Card

American Express
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Ladies Self Defense

Name
First Last
Phone
Email
Price
Price: $20.00
Credit Card

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Weight Loss for Life

ROCSPORTS HS Boys Basketball

ROC n Art Class

Women’s Only Fitness Center Orientation

Name
First Last
Phone
Email
Price
Price: $5.00
Credit Card

American Express
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MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name

Biggest Loser Page Sign Up

2019 ROCSPORTS Soccer Camp

2019 ROCSPORTS Basketball Camp

Women's Fitness Center Orientation

Name
First Last
Phone
Email
Price
Price: $5.00
Credit Card

American Express
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Visa
Card Number Expiration Date Security Code Cardholder Name

Sign Painting Class

Women's Only Fitness Center Orientation

Weight Loss for Life

Healthy Living with Diabetes

FAMILY PLAN

This is for immediate family members only living in the same household, consisting of 1+ parents and children under the age of 21

FULL FACILITY USERS

You will receive a green badge that will give you access to the walking track, basketball courts, and the fitness center

Walkers Only

You will be provided a purple badge providing access to the walking track only

Sign up today

Operating Hours

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Address

Payment Information

Payment Information

2020 ROCSPORTS High School BOYS Basketball

EMERGENCY AUTHORIZATION

Waiver of Liability and Disclaimer and Contract for Permission to Photograph

2020 ROCSPORTS Basketball Camp

EMERGENCY AUTHORIZATION

Waiver of Liability and Disclaimer and Contract for Permission to Photograph