Fall Ball Season 2017
Fall Ball Season 2017
Registration Date:_________
Manager/Head Coach:___________________________________________ Official Use Only
Address:_____________________________________________________________ City:________________________________________________________________ Paid Check#_____________ Cash:______________ Phone#:__________________________Cell#_________________________ Email:________________________________________________________ Asst. Coach:_________________________Phone #:___________________ Amount Paid:___________ Age Group:_____________
All Players must have ASA registration card at time of registration. Season begins September 10th through October 15th, 2017
(Board will verify and initial below)
Insurance Player Name Age Birthdate Parent/Guardian Verification 1.________________________________________________________________________________________ 2.________________________________________________________________________________________ 3.________________________________________________________________________________________ 4.________________________________________________________________________________________ 5.________________________________________________________________________________________ 6.________________________________________________________________________________________ 7.________________________________________________________________________________________ 8.________________________________________________________________________________________ 9.________________________________________________________________________________________ 10._______________________________________________________________________________________ 11._______________________________________________________________________________________ 12._______________________________________________________________________________________ 13._______________________________________________________________________________________ 14._______________________________________________________________________________________ 15._______________________________________________________________________________________ Consent for Medical Treatment As the parent or legal guardian of the above-named player, I hereby give my consent to the Five Cities Girls Softball for emergency medical care as prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb or well-being of my dependent. I release, discharge and agree not to sue the Five Cities Girls Softball or City of Arroyo Grande, their officers, umpires, agents, servants and employees for any claims, damages, costs or cause of action in the future resulting from the injury. (This league is required to have this document on file for 3 years.)
Registration Date:_________
Manager/Head Coach:___________________________________________ Official Use Only
Address:_____________________________________________________________ City:________________________________________________________________ Paid Check#_____________ Cash:______________ Phone#:__________________________Cell#_________________________ Email:________________________________________________________ Asst. Coach:_________________________Phone #:___________________ Amount Paid:___________ Age Group:_____________
All Players must have ASA registration card at time of registration. Season begins September 10th through October 15th, 2017
(Board will verify and initial below)
Insurance Player Name Age Birthdate Parent/Guardian Verification 1.________________________________________________________________________________________ 2.________________________________________________________________________________________ 3.________________________________________________________________________________________ 4.________________________________________________________________________________________ 5.________________________________________________________________________________________ 6.________________________________________________________________________________________ 7.________________________________________________________________________________________ 8.________________________________________________________________________________________ 9.________________________________________________________________________________________ 10._______________________________________________________________________________________ 11._______________________________________________________________________________________ 12._______________________________________________________________________________________ 13._______________________________________________________________________________________ 14._______________________________________________________________________________________ 15._______________________________________________________________________________________ Consent for Medical Treatment As the parent or legal guardian of the above-named player, I hereby give my consent to the Five Cities Girls Softball for emergency medical care as prescribed by a duly licensed Doctor of Medicine or Doctor of Dentistry. This care may be given under whatever conditions are necessary to preserve life, limb or well-being of my dependent. I release, discharge and agree not to sue the Five Cities Girls Softball or City of Arroyo Grande, their officers, umpires, agents, servants and employees for any claims, damages, costs or cause of action in the future resulting from the injury. (This league is required to have this document on file for 3 years.)
