Birth Date: Street Address: Sch
CREWE-BURKEVILLE YOUTH RECREATION ASSOCIATION 2017 Spring Sports Registration Form Registration Fee $50.00 (Early Registration is $45.00 until Feb 4th) ** Registration deadline is March 4, 2016. A $10.00 late fee will be charged after this date **
**Print Participants FULL Legal Name as printed on their Birth Certificate** Participant's Name:
Birth Date:
Street Address:
School:
City: Home Phone:
Zip:
Email:
Cell:
Other:
Shirt Size: Youth Pant Size Youth Hat Size: Youth
or Adult or Adult or Adult
Parent/Guardians' Name(s):
Softball Sweetees (4, 5 ,6) Darlings (6, 7, 8) Angels (9, 10) Pony Tails (11, 12) Belles (13, 14, 15) Debs (16, 17,18)
Baseball T-Ball (4, 5, 6) Instructional (6, 7, 8) Minor (8, 9, 10) Major (10, 11, 12) Babe Ruth (13, 14, 15) Babe Ruth (16, 17, 18)
Soccer 3 Year Old Program U6 (4, 5) U8 (6,7) U10 (8,9) U12 (10, 11) U14 (12, 13) U16 (14, 15) U18 (16, 17)
Please make your check payable to CBYRA. Completed forms and checks can be mailed to: CBYRA P. O. Box 395 Crewe, VA 23930
Please volunteer to help in one or more of the following activities: Team Manager Field Cleanup Asst. Coach Field lining on game day
Team Parent Field Maintenance Umpire Concession
I/We the parent(s)/guardian(s) of the above named child, hereby give my/our approval to his/her participation in any and all activities of the association during the current season. I/We assume all risks and hazards incidental to the conduct of the activities and transportation to and from the activities. I/We further hereby release, absolve, indemnify and hold harmless the association, organizers, sponsors, supervisors and persons transporting my/our child(ren) to or from the activities, any or all of them: for any claim arising out of injury to my/our child(ren), except to the extent covered by liability insurance. Name:____________________________________________Signature:__________________________________________ “Like” us on Facebook or visit our website at www.cbyra.com for upcoming and current events.
**Print Participants FULL Legal Name as printed on their Birth Certificate** Participant's Name:
Birth Date:
Street Address:
School:
City: Home Phone:
Zip:
Email:
Cell:
Other:
Shirt Size: Youth Pant Size Youth Hat Size: Youth
or Adult or Adult or Adult
Parent/Guardians' Name(s):
Softball Sweetees (4, 5 ,6) Darlings (6, 7, 8) Angels (9, 10) Pony Tails (11, 12) Belles (13, 14, 15) Debs (16, 17,18)
Baseball T-Ball (4, 5, 6) Instructional (6, 7, 8) Minor (8, 9, 10) Major (10, 11, 12) Babe Ruth (13, 14, 15) Babe Ruth (16, 17, 18)
Soccer 3 Year Old Program U6 (4, 5) U8 (6,7) U10 (8,9) U12 (10, 11) U14 (12, 13) U16 (14, 15) U18 (16, 17)
Please make your check payable to CBYRA. Completed forms and checks can be mailed to: CBYRA P. O. Box 395 Crewe, VA 23930
Please volunteer to help in one or more of the following activities: Team Manager Field Cleanup Asst. Coach Field lining on game day
Team Parent Field Maintenance Umpire Concession
I/We the parent(s)/guardian(s) of the above named child, hereby give my/our approval to his/her participation in any and all activities of the association during the current season. I/We assume all risks and hazards incidental to the conduct of the activities and transportation to and from the activities. I/We further hereby release, absolve, indemnify and hold harmless the association, organizers, sponsors, supervisors and persons transporting my/our child(ren) to or from the activities, any or all of them: for any claim arising out of injury to my/our child(ren), except to the extent covered by liability insurance. Name:____________________________________________Signature:__________________________________________ “Like” us on Facebook or visit our website at www.cbyra.com for upcoming and current events.
