Registration Form



[pic]

2017 Baseball Registration

Please check off which division you are registering your child for:

_______ (7-8yrs) Division 1 ________ (9-10 yrs) Division 2 _________(11-12yrs) Majors

_________ (11-13yrs) Elite 50/70 _________ (13-14 yrs) Juniors ________ (14-16yrs) Seniors

Division 1 to Majors Elite and Above

Upfront Non-refundable registration fee $150.00 $180.00

Volunteer Fee (1 per family) $75.00 $75.00

**Volunteer fee will be returned to you upon completion of volunteer hours.**

Name ____________________________________________________________________________

Address __________________________________________________________________________

Phone ____________________________________ Shirt Size: __________

DOB _______________ _____________ Age (AS OF AUG 31, 2017)

Parent/Guardian Name _____________________________________________

Email: __________________________________________________________

Medical Carrier: ________________________________ Medical Conditions: _________________________

Check # ___________________

A $25.00 FEE AND BANK FEES WILL BE APPLIED FOR ALL RETURNED CHECKS

MEDICAL RELEASE AND PARENT CONSENT FORM

I the parent/guardian of the registrant, a minor or adult registrant of legal age, agree that I and the registrant will abide by the rules of the Fairless Hills Athletic Association, its affiliated organization and sponsors. Recognizing the possibility of physical injury associated with sports and in consideration for the Fairless Hills Athletic Association, accepting the registrant for its programs and activities. I hereby release, discharge and for otherwise indemnify the Fairless Hills Athletic Association, its affiliated organizations and sponsors, their employees and associated personnel, including the owners of the fields and facilities utilized for the programs, against any claim by or on behalf of the registrant as a result of the registrants participation in the program and/or being transported to or from the same, which transportation I hereby authorize. The above minor has my permission to participate in the Fairless Hills Athletic Association's Sports programs. In consideration of your acceptance of my enrollment, I the player, and we the parents, individually and collectively, intending to legal bound hereby for ourselves and heirs, executors and administrators, waive and release Fairless Hills Athletic Association, their agents and representatives from any and all claims or the rights to damages for injuries or losses suffered by me, the player, directly or indirectly, in training for, or traveling to or from or competing in or while attending any future Fairless Hills Athletic Association functions. I acknowledge the registration fee only includes secondary accident insurance. As the parent or legal guardian of the above named player, I hereby give my consent for medical care prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve the live, limb, or well being of my dependent.

Parent/Guardian Signature: ________________________________________________________ Date:_____________________

................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download