2017 KYAA Fall Baseball Registration Form
2017 KYAA Fall Baseball Registration Form Complete the form below using a separate form for each player. Attach a check or money order for all fees payable to KYAA. Mail registration to: KYAA Fall Ball Registration, ℅ Chris Holt, 320 Trexler Ave., Kutztown, PA 19530 or register online at www.leaguelineup.com/kyaa. Please direct questions about Fall Baseball to Chris Holt, [email protected] (preferred) or 610-463-8882.
Player’s Full Name _______________________________________________
Date of Birth _____/_____/_____
List any serious physical or medical limitations ________________________________________________________ List other fall sports played and which team (eg: U8, U10, Mites, Mighty Mites) and other scheduling conflicts for Fri., Sat., Sun. games __________________________________________________________________________________ Father/Guardian Name _______________________________
Home Ph. ________________ Cell Ph._____________
Street Address _____________________________________________ Email____________________________ Mother/Guardian Name _______________________________ Home Ph. ________________ Cell Ph._____________ Street Address _____________________________________________ Email ____________________________
Eligibility Coach Pitch Fall Baseball - boys and girls, age 6 - 8 as of May 1, 2018. Jr. Fall Baseball - boys and girls, age 8 - 10 as of May 1, 2018. Sr. Fall Baseball - boys and girls, age 11 - 12 as of May 1, 2018. Babe Ruth Fall Baseball - boys, age 13 - 15 as of May 1, 2018. Please indicate volunteer areas in which you would be willing to help out your child’s team. ___ Head Coach ___ Asst. Coach ___ Field Prep ___ Scorebox ___ Team Mom/Dad
Medical Release As parent or guardian of the child indicated on this form, I grant my permission for this child’s participation in KYAA Fall Baseball for the 2017 season. I understand that inherent in these sporting activities is some risk of physical injury, and I release KYAA and its officers, directors and coaches from liability for injury incurred in all league activities. I also grant my permission to KYAA and its representatives to secure any and all emergency medical treatment required by my child in my absence. Parent/Guardian signature _____________________________________
Registration Fee (due by 7/15/17; late registrations add $10, 7/16 - 7/31; add $20 on or after 8/1; no registrations accepted after teams are full)
Uniform Fee Players supply their own pants, socks, and cleats. KYAA does still have stock in pants, which are free if you’d like a pair. Each player is required to purchase a blue Kutztown uniform tshirt and/or hat if he/she doesn’t already have one.
Total
Coach Pitch Fall Baseball (ages 6-8) $15.00 Jr. Fall Baseball (ages 8-10) $35.00 Sr. Fall Baseball (ages 11-12) $45.00 Babe Ruth Fall Baseball(ages 13-15) $55.00
$15 (if shirt is needed) Size: ___YS (6-8) ___ YM (10-12) ___ YL (14-16) ___ AS ___ AM ___ AL List top three number choices to be printed on shirt ___, ___, ___
$15 (if hat is needed) $_____
Player’s Full Name _______________________________________________
Date of Birth _____/_____/_____
List any serious physical or medical limitations ________________________________________________________ List other fall sports played and which team (eg: U8, U10, Mites, Mighty Mites) and other scheduling conflicts for Fri., Sat., Sun. games __________________________________________________________________________________ Father/Guardian Name _______________________________
Home Ph. ________________ Cell Ph._____________
Street Address _____________________________________________ Email____________________________ Mother/Guardian Name _______________________________ Home Ph. ________________ Cell Ph._____________ Street Address _____________________________________________ Email ____________________________
Eligibility Coach Pitch Fall Baseball - boys and girls, age 6 - 8 as of May 1, 2018. Jr. Fall Baseball - boys and girls, age 8 - 10 as of May 1, 2018. Sr. Fall Baseball - boys and girls, age 11 - 12 as of May 1, 2018. Babe Ruth Fall Baseball - boys, age 13 - 15 as of May 1, 2018. Please indicate volunteer areas in which you would be willing to help out your child’s team. ___ Head Coach ___ Asst. Coach ___ Field Prep ___ Scorebox ___ Team Mom/Dad
Medical Release As parent or guardian of the child indicated on this form, I grant my permission for this child’s participation in KYAA Fall Baseball for the 2017 season. I understand that inherent in these sporting activities is some risk of physical injury, and I release KYAA and its officers, directors and coaches from liability for injury incurred in all league activities. I also grant my permission to KYAA and its representatives to secure any and all emergency medical treatment required by my child in my absence. Parent/Guardian signature _____________________________________
Registration Fee (due by 7/15/17; late registrations add $10, 7/16 - 7/31; add $20 on or after 8/1; no registrations accepted after teams are full)
Uniform Fee Players supply their own pants, socks, and cleats. KYAA does still have stock in pants, which are free if you’d like a pair. Each player is required to purchase a blue Kutztown uniform tshirt and/or hat if he/she doesn’t already have one.
Total
Coach Pitch Fall Baseball (ages 6-8) $15.00 Jr. Fall Baseball (ages 8-10) $35.00 Sr. Fall Baseball (ages 11-12) $45.00 Babe Ruth Fall Baseball(ages 13-15) $55.00
$15 (if shirt is needed) Size: ___YS (6-8) ___ YM (10-12) ___ YL (14-16) ___ AS ___ AM ___ AL List top three number choices to be printed on shirt ___, ___, ___
$15 (if hat is needed) $_____
