2014 West Bend Girls Fast Pitch Softball
___ ___ ___ ___ ___
10U 12U 14U 16U 18U
LEAGUE AGE DESCRIPTION: (must be 10 or younger on 12/31/17) (must be 12 or younger on 12/31/17) (must be 14 or younger on 12/31/17) (must be 16 or younger on 12/31/17) (must be 18 or younger on 12/31/17)
This form must be completed by Participant and/or Parent/Guardian before a player may participate in the Nitro events. (Please Print)
PARTICIPANT’S INFORMATION: NAME: BIRTHDATE:
AGE AS OF DECEMBER 31, 2017
ADDRESS: CITY:
ZIP CODE:
HOME PHONE #:
PARENT/GUARDIAN NAME(s): PARENT/GUARDIAN CELL #: PARENT/GUARDIAN CELL #: PARENT/GUARDIAN E-MAIL: EMERGENCY CONTACT:
PHONE:
PREVIOUS TEAM/ORGANIZATION THAT CHILD PLAYED FOR (IF ANY):
TRYOUT NUMBER (Nitro staff use):
This form must be completed by Participant and/or Parent/Guardian before a player may participate in Nitro events. (Please Print)
I, ___________________________________ (Participant name) WISH TO PARTICIPATE IN WEST BEND NITRO FASTPITCH SOFTBALL CLUB TRYOUTS, PRACTICES AND/OR GAMES: If under the age of 18, my Parent/Guardian will sign on my behalf. I, and/or my Parent/Guardian, agrees to abide by all rules and regulations established for this activity, including the West Bend Nitro Girls Fastpitch Club Player Handbook, a copy of which is available upon request, and will be provided to you should you accept a position on a Nitro team. I, and/or my Parent/Guardian, am aware that participation in Nitro events are vigorous team activities that can involve severe cardiovascular stress and violent physical contact. I, and/or my Parent/Guardian, understand that participation in Nitro events can involve certain risks, including, but not limited to, death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damage, and serious injury to virtually all bones, joints, muscles, and internal organs, and that equipment provided for my protection may be inadequate to prevent serious injury. In addition, I, and/or my Parent/Guardian, understand that participation in Nitro events involves activities incidental thereto, including, but not limited to, travel to and from the site of the activity, participation at sites that may be remote from available medical assistance, and the possible reckless conduct of other participants. I, and/or my Parent/Guardian, am voluntarily participating in this activity with knowledge of the danger involved and hereby agree to accept any and all risks of property damage, personal injury, or death. I, and/or my Parent/Guardian, have been informed about the various risks associated with my child’s participation in this activity and the potential injuries that may occur. I, and/or my Parent/Guardian, assume all responsibility and certify that my child is in good physical condition. Further, I, and/or my Parent/Guardian, am unaware of any medical condition that would inhibit my child’s participation. I have sufficient insurance and am willing to take full financial responsibility for any and all injuries sustained by my child while participating in this activity. In consideration of my, and/or our child’s participation, in Nitro events, I, and/or my Parent/Guardian, hereby forever release and covenant not-to-sue Nitro, the Nitro Board of Directors, and any of their employees, instructors, volunteers, agents, coaches, and all others who are involved, from any and all present and future claims resulting from ordinary negligence on the part of Nitro or others listed for property damage, personal injury, or wrongful death, arising as a result of my engaging in or receiving instruction in club sports activities or any activities incidental thereto, wherever, whenever, or however the same may occur. I, and/or my Parent/Guardian, hereby voluntarily waive any and all claims both present and future, resulting from ordinary negligence, that may be made by me, my family, estate, heirs, or assigns, and I relinquish on behalf of myself, spouse, heirs, estate and assigns the right to recover for injury or death.
Participant
Print Name: West Bend Nitro Fastpitch Softball Participant
SIGNED:
Date: Participant Parent/Legal Guardian
Parent/Guardian:
Date:
Parent/Guardian Signature if Participant under 18
West Bend Nitro Fastpitch Softball Club Approval
APPROVED BY:
Date: West Bend Nitro Fastpitch Softball Club Director
10U 12U 14U 16U 18U
LEAGUE AGE DESCRIPTION: (must be 10 or younger on 12/31/17) (must be 12 or younger on 12/31/17) (must be 14 or younger on 12/31/17) (must be 16 or younger on 12/31/17) (must be 18 or younger on 12/31/17)
This form must be completed by Participant and/or Parent/Guardian before a player may participate in the Nitro events. (Please Print)
PARTICIPANT’S INFORMATION: NAME: BIRTHDATE:
AGE AS OF DECEMBER 31, 2017
ADDRESS: CITY:
ZIP CODE:
HOME PHONE #:
PARENT/GUARDIAN NAME(s): PARENT/GUARDIAN CELL #: PARENT/GUARDIAN CELL #: PARENT/GUARDIAN E-MAIL: EMERGENCY CONTACT:
PHONE:
PREVIOUS TEAM/ORGANIZATION THAT CHILD PLAYED FOR (IF ANY):
TRYOUT NUMBER (Nitro staff use):
This form must be completed by Participant and/or Parent/Guardian before a player may participate in Nitro events. (Please Print)
I, ___________________________________ (Participant name) WISH TO PARTICIPATE IN WEST BEND NITRO FASTPITCH SOFTBALL CLUB TRYOUTS, PRACTICES AND/OR GAMES: If under the age of 18, my Parent/Guardian will sign on my behalf. I, and/or my Parent/Guardian, agrees to abide by all rules and regulations established for this activity, including the West Bend Nitro Girls Fastpitch Club Player Handbook, a copy of which is available upon request, and will be provided to you should you accept a position on a Nitro team. I, and/or my Parent/Guardian, am aware that participation in Nitro events are vigorous team activities that can involve severe cardiovascular stress and violent physical contact. I, and/or my Parent/Guardian, understand that participation in Nitro events can involve certain risks, including, but not limited to, death, serious neck and spinal injuries resulting in complete or partial paralysis, brain damage, and serious injury to virtually all bones, joints, muscles, and internal organs, and that equipment provided for my protection may be inadequate to prevent serious injury. In addition, I, and/or my Parent/Guardian, understand that participation in Nitro events involves activities incidental thereto, including, but not limited to, travel to and from the site of the activity, participation at sites that may be remote from available medical assistance, and the possible reckless conduct of other participants. I, and/or my Parent/Guardian, am voluntarily participating in this activity with knowledge of the danger involved and hereby agree to accept any and all risks of property damage, personal injury, or death. I, and/or my Parent/Guardian, have been informed about the various risks associated with my child’s participation in this activity and the potential injuries that may occur. I, and/or my Parent/Guardian, assume all responsibility and certify that my child is in good physical condition. Further, I, and/or my Parent/Guardian, am unaware of any medical condition that would inhibit my child’s participation. I have sufficient insurance and am willing to take full financial responsibility for any and all injuries sustained by my child while participating in this activity. In consideration of my, and/or our child’s participation, in Nitro events, I, and/or my Parent/Guardian, hereby forever release and covenant not-to-sue Nitro, the Nitro Board of Directors, and any of their employees, instructors, volunteers, agents, coaches, and all others who are involved, from any and all present and future claims resulting from ordinary negligence on the part of Nitro or others listed for property damage, personal injury, or wrongful death, arising as a result of my engaging in or receiving instruction in club sports activities or any activities incidental thereto, wherever, whenever, or however the same may occur. I, and/or my Parent/Guardian, hereby voluntarily waive any and all claims both present and future, resulting from ordinary negligence, that may be made by me, my family, estate, heirs, or assigns, and I relinquish on behalf of myself, spouse, heirs, estate and assigns the right to recover for injury or death.
Participant
Print Name: West Bend Nitro Fastpitch Softball Participant
SIGNED:
Date: Participant Parent/Legal Guardian
Parent/Guardian:
Date:
Parent/Guardian Signature if Participant under 18
West Bend Nitro Fastpitch Softball Club Approval
APPROVED BY:
Date: West Bend Nitro Fastpitch Softball Club Director
