Registration Form 2014-allx
BMSA Girls Youth Softball 2016 Seasonal Registration SPRING
Mail to: BMSA Softball ~ P.O. Box 265 ~ Blackstone, MA 01504 (Please include this form along with your check)
www.bmsasoftball.org Blackstone-Millville Softball Association Youth Girls Seasonal Fast Pitch Softball Player/League Information Please fill in the non-shaded areas –Circle where required
Player Name
Date of Birth
Parents Name
Age as of 1/1/2016
Street Address
Home Phone
Town – Zip Code
Cell Phone
Alternate Contact
Email (primary mode of communication)
Yes
Are You a Pitcher
No
Positions Played
Shirt Size
YS – YM – YL – AS – AM – AL – AXL – AXXL
Other Sports Played
Sock Size
Small (4-7) – Medium (7-9) – Large (9-11)
If So, What Sports Softball experience
Program
Game Locations
Notes
Cost
Youth Instructional Age 4-7
Blackstone
1
$25.00
U8 (under 8 before 1/1/2016)
Memorial Field Mendon
1
$40.00
BVGSL Travel Ages 8 – 14 Tryouts required for U10 + unless previously played with BVGSL In-Town age 9-17
Mendon, Uxbridge, Douglas, Blackstone, Milford, Northbridge, Bellingham
2
$50.00
None
2
Blackstone
$50.00
No
1-3 years
3+ years
No refunds after April 30th
Games (Based on field availability)
Practice
Saturdays or Sundays (to avoid conflicts with other sports) Saturdays / maybe one weeknight
None
Mon./Wed. or Tue./Thur. U10 plays Tues & Thursday U12 plays Mon & Wed U14 plays Tues & Thursday
Friday, Saturday and / or Sun. 2 nights on weekends
Coach preference – generally one night Coach preference: Weeknights – Weekends Generally one night
Weeknights
Each program is separate. If you choose to sign up for Travel and Town it is $100 registration -------------------------------------League Assistance – Help Is Always Needed Coach a Team Assist a Coach Sponsor a Team Volunteer/Fundraising Yes
Notes
Yes
PRICES BASED ON REGISTRATION BEFORE MARCH 1, 2016
AGE as of 1/1/2016
X
1B – 2B – 3B – SS – OF – C – P
No 3
Yes
No 3
Yes ($200.00/team) No (if yes, list below)
Yes
No 4
Notes: 1) 2) 3) 4)
Uniforms include tee shirts and socks; games played without umpires Uniforms include tee shirts and socks; games played with umpires State of Massachusetts CORI verification back ground check is required Will typically involve the concession stand, but other events may occur during the softball seasons
BMSA 2016 Fast Pitch Division Parental Waiver, Release of Liability, Indemnification Consent I understand that there are certain risks of damages and injuries, including death, inherent in the practice and play of softball, as well as in traveling and other related activities incidental to my daughter’s participation, and I am willing to assume these risks. These risks include but are not limited to those hazards associated with weather conditions, travel, playing conditions, equipment and other participants. I understand that sliding into base is dangerous to my daughter and other players and may result in serious injury or death. I understand that the very nature of the game of softball is hazardous and risky, including, but limited to, the acts of pitching, throwing, fielding and catching the ball, swinging of the bat, running, jumping, stretching, sliding, diving, and collisions of other players and with stationary objects, all of which can cause serious injury or death to my daughter and to other players. Further, I agree that in consideration for the right to allow my daughter to participate as a member of the league and division designated below and in consideration for permission to play on the fields arranged for by the team or league: 1)
2)
I do voluntarily elect to accept and solely assume all risks of injury my daughter may incur or suffer (a) while practicing or playing as a member of the team so designated, (b) while serving in a non-playing capacity as a team member or observer during practice or play by other teams or by other players on my team, and (c) while on or upon the premises of any and all fields arranged by her team or league for practice or play, In addition to giving my full consent for my daughter’s participation, I do hereby waive, release, discharge and agree not to sue the team and league designated below, the owner or operator of any field or other entity designated below, The Amateur Softball Association of America, or their owners, officers, agents, servants, associations, employees, or any person or entity connected with the team, league, field, or Amateur Softball Association of America for any claims, damages, costs including attorney fees, or cause of action which I have or may have in the future as a result of damages, injuries, including death, sustained or incurred by my daughter from whatever cause including but not limited to the negligence, breach of contract or wrongful conduct hereby released.
I hereby certify that my daughter is fully capable of participating in the designated sport and that she is healthy and has no physical or mental disabilities or infirmities that would restrict full participation in these activities, except as made known to coaches and officials of the team and league. I further agree that I shall hold harmless and fully indemnify the parties hereby released from any and all claims, damages, costs including attorney fees and causes of action which may arise from any cause of action made by me or by, through or on my behalf, even if the damages, injuries or death are caused in whole or in part by any of the persons or entities hereby released.
Player Name
Date
Parents Signature
Amount Paid
Medical Condition
Yes
No
(if yes, explain below)
Cash/Check #
Allergies
Yes
No
(if yes, explain below)
Verified By (BMSA)
Blackstone-Millville Softball Association (BMSA) PO BOX 265 Blackstone, MA 01504 Contact us: at [email protected]
Find us and “like” us on Facebook @ BMSA SOFTBALL NEW Website as of 2016:
www.bmsasoftball.org
Open meetings are 2nd Wednesday of the month at the Blackstone Senior Center @ 6:15pm All are welcome and encouraged to attend
Mail to: BMSA Softball ~ P.O. Box 265 ~ Blackstone, MA 01504 (Please include this form along with your check)
www.bmsasoftball.org Blackstone-Millville Softball Association Youth Girls Seasonal Fast Pitch Softball Player/League Information Please fill in the non-shaded areas –Circle where required
Player Name
Date of Birth
Parents Name
Age as of 1/1/2016
Street Address
Home Phone
Town – Zip Code
Cell Phone
Alternate Contact
Email (primary mode of communication)
Yes
Are You a Pitcher
No
Positions Played
Shirt Size
YS – YM – YL – AS – AM – AL – AXL – AXXL
Other Sports Played
Sock Size
Small (4-7) – Medium (7-9) – Large (9-11)
If So, What Sports Softball experience
Program
Game Locations
Notes
Cost
Youth Instructional Age 4-7
Blackstone
1
$25.00
U8 (under 8 before 1/1/2016)
Memorial Field Mendon
1
$40.00
BVGSL Travel Ages 8 – 14 Tryouts required for U10 + unless previously played with BVGSL In-Town age 9-17
Mendon, Uxbridge, Douglas, Blackstone, Milford, Northbridge, Bellingham
2
$50.00
None
2
Blackstone
$50.00
No
1-3 years
3+ years
No refunds after April 30th
Games (Based on field availability)
Practice
Saturdays or Sundays (to avoid conflicts with other sports) Saturdays / maybe one weeknight
None
Mon./Wed. or Tue./Thur. U10 plays Tues & Thursday U12 plays Mon & Wed U14 plays Tues & Thursday
Friday, Saturday and / or Sun. 2 nights on weekends
Coach preference – generally one night Coach preference: Weeknights – Weekends Generally one night
Weeknights
Each program is separate. If you choose to sign up for Travel and Town it is $100 registration -------------------------------------League Assistance – Help Is Always Needed Coach a Team Assist a Coach Sponsor a Team Volunteer/Fundraising Yes
Notes
Yes
PRICES BASED ON REGISTRATION BEFORE MARCH 1, 2016
AGE as of 1/1/2016
X
1B – 2B – 3B – SS – OF – C – P
No 3
Yes
No 3
Yes ($200.00/team) No (if yes, list below)
Yes
No 4
Notes: 1) 2) 3) 4)
Uniforms include tee shirts and socks; games played without umpires Uniforms include tee shirts and socks; games played with umpires State of Massachusetts CORI verification back ground check is required Will typically involve the concession stand, but other events may occur during the softball seasons
BMSA 2016 Fast Pitch Division Parental Waiver, Release of Liability, Indemnification Consent I understand that there are certain risks of damages and injuries, including death, inherent in the practice and play of softball, as well as in traveling and other related activities incidental to my daughter’s participation, and I am willing to assume these risks. These risks include but are not limited to those hazards associated with weather conditions, travel, playing conditions, equipment and other participants. I understand that sliding into base is dangerous to my daughter and other players and may result in serious injury or death. I understand that the very nature of the game of softball is hazardous and risky, including, but limited to, the acts of pitching, throwing, fielding and catching the ball, swinging of the bat, running, jumping, stretching, sliding, diving, and collisions of other players and with stationary objects, all of which can cause serious injury or death to my daughter and to other players. Further, I agree that in consideration for the right to allow my daughter to participate as a member of the league and division designated below and in consideration for permission to play on the fields arranged for by the team or league: 1)
2)
I do voluntarily elect to accept and solely assume all risks of injury my daughter may incur or suffer (a) while practicing or playing as a member of the team so designated, (b) while serving in a non-playing capacity as a team member or observer during practice or play by other teams or by other players on my team, and (c) while on or upon the premises of any and all fields arranged by her team or league for practice or play, In addition to giving my full consent for my daughter’s participation, I do hereby waive, release, discharge and agree not to sue the team and league designated below, the owner or operator of any field or other entity designated below, The Amateur Softball Association of America, or their owners, officers, agents, servants, associations, employees, or any person or entity connected with the team, league, field, or Amateur Softball Association of America for any claims, damages, costs including attorney fees, or cause of action which I have or may have in the future as a result of damages, injuries, including death, sustained or incurred by my daughter from whatever cause including but not limited to the negligence, breach of contract or wrongful conduct hereby released.
I hereby certify that my daughter is fully capable of participating in the designated sport and that she is healthy and has no physical or mental disabilities or infirmities that would restrict full participation in these activities, except as made known to coaches and officials of the team and league. I further agree that I shall hold harmless and fully indemnify the parties hereby released from any and all claims, damages, costs including attorney fees and causes of action which may arise from any cause of action made by me or by, through or on my behalf, even if the damages, injuries or death are caused in whole or in part by any of the persons or entities hereby released.
Player Name
Date
Parents Signature
Amount Paid
Medical Condition
Yes
No
(if yes, explain below)
Cash/Check #
Allergies
Yes
No
(if yes, explain below)
Verified By (BMSA)
Blackstone-Millville Softball Association (BMSA) PO BOX 265 Blackstone, MA 01504 Contact us: at [email protected]
Find us and “like” us on Facebook @ BMSA SOFTBALL NEW Website as of 2016:
www.bmsasoftball.org
Open meetings are 2nd Wednesday of the month at the Blackstone Senior Center @ 6:15pm All are welcome and encouraged to attend
