Register by
City of Moraine’s
May 15th
50th Anniversary
Commemorative Home Run Derby
$50 prize for the winner of each age group
First Rounds begin Wednesday, May 27th @ 6:00pm
Final rounds held at the City of Moraine’s 50th Anniversary Bash on Friday, May 29th.
Registration Form/Rules
1. Contest will consist of 3 rounds.
Round 1 every batter will hit a total of 10 outs. A batter does not have to swing at every pitch, but missed swings, foul balls, and any
ball that is not a home run is considered 1 out. Ball must be hit into fair territory to be counted as a home run. Home runs do not
count as an out. Top 4 hitters will advance to Round 2. If players tie, they will get 3 more outs. Player with the most home runs at
the end of the tie breaker round advances. If still equal amounts of home runs then most amount consecutive advances. *Max
Number of 10 to qualify for the next round.
Round 2 (same as Round 1). Top 2 advance to finals.
Round 3 Finals Top 2 players get 5 outs per bat. If players tie, will go into “extra innings’. Players will get 5 more outs.
2. Top player in each age group wins $50, trophies for First and Second Place
3. This derby will be for all ages. Age categories will be broken down evenly based on registration. Girls’ and Boys’ Divisions. Times
will be assigned, minimum number of 10 per group/ max number of 20. $10 entry fee must be paid at the time of registration. Each
participant will receive a shirt, the night of the opening rounds.
4. Players must provide their own pitcher. If you cannot find a pitcher please indicate on your form and we will do our best to
accommodate your needs.
Entry Fee is only $10
Each contestant receives a T-Shirt
Player Name:_________________________________________________________ Age:_________________________
Phone Number: _________________________________________ Email: _____________________________________
Shirt Size: (please circle)
Small
Medium
Large
X-Large
2X-Large
Please make checks payable to the Moraine Foundation. Forms maybe returned via mail to 4200 Dryden Rd., Moraine, OH 45439. For more
information contact the Payne Recreation Center at 535-1060 or our website at www.ci.moraine.
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City of Moraine’s
50th Anniversary
Commemorative Home Run/WiffleBall Derby
Participant Waiver
BY AFFIXING MY SIGNATURE TO THE PLAYERS' CONTRACT/ROSTER, I HAVE READ, UNDERSTOOD, ACKNOWLEDGE
AND AGREE TO ABIDE BY WITH EACH AND EVERY ONE OF THE BELOW PROVISIONS IN THIS WAIVER, RELEASE OF
LIABILITY AND INDEMNIFICATION AGREEMENT.
I, the undersigned player, acknowledge, agree and understand that; voluntarily and of my own free will, I elect to
participate as a member of the Homerun Derby/Wiffleball team, and understand the rules associated with the contest.
I acknowledge that this recreational activity may be an extreme test of a person’s physical and mental limits and carries
with it the potential for death, serious injury and property loss. I certify that I am physically fit and have not been
advised otherwise by a qualified medical person. I understand that there are certain risks and hazard involved in
participating in a Homerun Derby or on a Wiffleball team including, but not limited to those hazards associated with
weather, water, terrain and playing conditions, facilities, equipment, vehicular traffic, lack of hydration and actions of
other people but not limited to, participants, volunteers, spectators, coaches, officials, staff members and other
participants
I further agree that I shall hold harmless and full indemnify the parties hereby released from any claims, damages, costs,
including attorney fees, and cause of action which may arise from any claim or cause of action made by me, through me
or on my behalf even if damages, injuries or death are caused in whole or part by any of the parties or entities hereby
released.
I understand that during my participation in the City of Moraine 50th anniversary activities or events, my photo may be
taken. I agree to allow my photo, video or film likeness to be used for any legitimate purpose by the event holders,
producers, sponsors, organizers and/or signs.
X__________________________________________ Date_______________________________
Player (Over 18)
X__________________________________________ Date_______________________________
Parent of Legal Guardian (under 18)
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