2017 Boys and Girls Registration

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Printing courtesy of: TAP Business Systems 1301 E Jackson St – Pana, IL 62557 217-562-5027

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2017 Boys and Girls Registration T-Ball (boys & girls) Ages 5-6

www.pybso.com

T-Ball and Boys Baseball eligibility is determined by player’s age as of April 30. Girls Softball eligibility is determined by player’s age as of July 31.

Child’s Name: Date of Birth:

Boys Baseball Ages 7-8 Ages 9-10 Ages 11-12 (will travel) Ages 13-14 (will travel)

Male

Female

Home Address: City, State, Zip: Contact Number(s): Email: If you would like to receive informational text messages from PYBSO, a valid cell phone number and email address are required.

Girls Softball Ages 7-8 Ages 9-10 (potential travel) Ages 11-12 (potential travel) Ages 13-15 (will travel)

PRICES (per player) $35 – Ages 5-8 $45 – Ages 9-16

Player’s Shirt Size

FAMILY DISCOUNTS 2 players = $10 off 3 players = $20 off 4 players = $30 off

Youth XS 4-5 Youth SM 6-8 Youth Med 10-12 Youth LG 14-16

Adult SM Adult Med Adult LG Adult XL

Registrations are due by March 1st, 2017. FEES ARE DUE AT THE TIME OF REGISTRATION Mail to: PYBSO - PO Box 81 - Pana, IL 62557 or Return to School List any physical/medical conditions we should know about your child:

I/We, the parents of the above child, hereby give my/our permission and approval to his/her participation in any and all activities during the current season. I/We do hereby waive, release, absolve, indemnify, and agree to hold harmless the Pana Youth Baseball Softball organizers, sponsors, supervisors, officials, and persons transporting the above named child, except to the extent, and in the amount covered by accident or liability insurance. Parents are responsible for transportation. Parent/Guardian: Signature

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I am interested in being: Head Coach Assistant Coach Concession Stand Helper Umpire PYBSO use only Payment Date:

Name (please print) Phone Email

Cash Amount: Received by:

Check Amount:

Check #: