2013 Callery Park Fall Baseball Registration
2013 Callery Park Fall Baseball Registration Name: _________________________________________________________________________________ Date of Birth: ______________________________________AGE (2013 Season):______________________ Address: _______________________________________________________________________________ ________________________________________________________________________________________ Phone #: _____________________________________ Cell #: ____________________________________ Team/Level last played: _______________________________________________________________ Email Address: ____________________________________________________________________ Special Request: ______________________________________________________________________ ** To be with other player or coach** (Some requests may not be met)
Payment Received: Check # _____________ or (mail in or at registration) Cash __________ (Do Not Mail cash) ***************************************************************************************** I the Parent/Guardian of the above mentioned player, voluntarily and knowingly accept and assume all risks and release Callery Park Baseball, it’s staff, any of its volunteers, and any related parties from liability due to injury, loss, costs, or damage, including without limitations, all claims, he/she or I may have for personal injury which may in any way arise out of participating in the above mentioned Baseball League. In case of emergency, if family/guardian cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel (ie, EMT, First Responder, and E.R. Physician). Parent or Guardian (Print):_________________________________________________________________ Parent or Guardian (Signature): ____________________________________________________________ Emergency contact phone #’s: ______________________________________________________________ ***************************************************************************************** Make Checks payable to: Callery Park Little League
Mail it to: Dan Capone C/O Callery Park Fall Baseball 63 West Meadow Rd. Lowell, Ma 01854 ***Do not send cash*** Fill out and bring registration and payment. ****Callery Park Fall baseball reserves the right to reject players or place them on a waiting list, due to rosters becoming to full,(15 players) no registrations will be accepted after Sept 1st, unless roster space is still available, for that information check our website @ www.leaguelineup.com/callery or call Dan Capone 978-453-9404 or Jay Normandie 978-804-0859****
Payment Received: Check # _____________ or (mail in or at registration) Cash __________ (Do Not Mail cash) ***************************************************************************************** I the Parent/Guardian of the above mentioned player, voluntarily and knowingly accept and assume all risks and release Callery Park Baseball, it’s staff, any of its volunteers, and any related parties from liability due to injury, loss, costs, or damage, including without limitations, all claims, he/she or I may have for personal injury which may in any way arise out of participating in the above mentioned Baseball League. In case of emergency, if family/guardian cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel (ie, EMT, First Responder, and E.R. Physician). Parent or Guardian (Print):_________________________________________________________________ Parent or Guardian (Signature): ____________________________________________________________ Emergency contact phone #’s: ______________________________________________________________ ***************************************************************************************** Make Checks payable to: Callery Park Little League
Mail it to: Dan Capone C/O Callery Park Fall Baseball 63 West Meadow Rd. Lowell, Ma 01854 ***Do not send cash*** Fill out and bring registration and payment. ****Callery Park Fall baseball reserves the right to reject players or place them on a waiting list, due to rosters becoming to full,(15 players) no registrations will be accepted after Sept 1st, unless roster space is still available, for that information check our website @ www.leaguelineup.com/callery or call Dan Capone 978-453-9404 or Jay Normandie 978-804-0859****
