Washington County Girls Softball League Fall Ball Registration ... - AWS
Washington County Girls Softball League Fall Ball Registration Registration Fee $25.00 Date: ________ School:__________________________________ Grade: _________ Birth Date: _________ PLAYER’S NAME:______________________________________________________________ Parent/Guardian # 1
Main Contact
Parent/Guardian # 2
Secondary Contact
Name: _________________________________________
Name: ________________________________________
Address:_______________________________________
Address:______________________________________
________________________________________
______________________________________________
Home Phone # ____________________________
Home Phone # ____________________________
Cell Phone # ____________________________
Cell Phone # ____________________________
Email: _________________________________________
Email: _______________________________________
Please place a x next to one phone Number best to call
Please place a X next to one phone Number best to call
Spring Team Name: ______________________________ Please Circle Shirt Size: YS
YM
YL
YXL
AS
AM
AL
AXL
AXXL
AXXXL
Uniform Number 1st Choice: ______ 2nd Choice: ______ Emergency Care Information Physician Name:____________________________________________________ Phone:_________________________________ Insurance Company:___________________________________________ Policy Number:________________________________
Emergency Contact:
(List Someone Other Than Yourself)
Name:_______________________________________Phone:1st ________________________Phone:2nd ______________________ Address:__________________________________________________City:________________________________State:__________ IMPORTANT INFORMATION PLEASE SIGN BELOW
I hereby acknowledge that I received and read the concussion information, parental permission to play/waiver, concession stand guidelines and WCGSL jewelry policy. I certify that I understand ALL the information that has been provided to me by signing below. WCGSL PARENTAL PERMISSION TO PLAY / WAIVER I, the parent or guardians of the named applicant, give approval to my child’s participation in all activities of the Washington County Girls Softball League. I assume all risks and hazards incidental to such participation including transportation to and from all activities. I do hereby waive, release, absolve, and indemnify, and agree to hold harmless Washington County Girls Softball League and Pony Softball. The organizers, coaches, sponsors, league officials, other participants, and appointed persons transporting my child to or from program activities for any claims arising out of injury to my child incidental to such participation, except to the extent and amount covered by accident and/or liability insurance held by Washington County Girls Softball League. I further agree that in my absence, the designated league officers, and/or team coaches shall have authority to take action, as deemed necessary, to provide or render immediate medical attention to the above named applicant due to sudden illness or injury incidental to, or occurring during her participation. WCGSL/Pony Softball Jewelry Policy Players are not allowed to wear any jewelry during practices and games. This includes piercings, rings, watches, bracelets, and necklaces. Players must remove all jewelry prior to practices and/or games; this will include even new piercings. Please be aware of this a avoid problems by delaying any new piercings until after the softball season. NOTE: Medical bracelets and necklaces are not considered jewelry, but if worn must be taped to the body.
Parent/Guardian Signature:
Athlete Signature:
Date:
LEAGUE USE ONLY Payment
Cash Check # ____________
Registration Fee:_________
Amount Paid: ___________
THIS FORM MUST BE WITH MANAGER/COACH AT ALL W.C.G.S.L. ACTIVITIES.
7/17
Main Contact
Parent/Guardian # 2
Secondary Contact
Name: _________________________________________
Name: ________________________________________
Address:_______________________________________
Address:______________________________________
________________________________________
______________________________________________
Home Phone # ____________________________
Home Phone # ____________________________
Cell Phone # ____________________________
Cell Phone # ____________________________
Email: _________________________________________
Email: _______________________________________
Please place a x next to one phone Number best to call
Please place a X next to one phone Number best to call
Spring Team Name: ______________________________ Please Circle Shirt Size: YS
YM
YL
YXL
AS
AM
AL
AXL
AXXL
AXXXL
Uniform Number 1st Choice: ______ 2nd Choice: ______ Emergency Care Information Physician Name:____________________________________________________ Phone:_________________________________ Insurance Company:___________________________________________ Policy Number:________________________________
Emergency Contact:
(List Someone Other Than Yourself)
Name:_______________________________________Phone:1st ________________________Phone:2nd ______________________ Address:__________________________________________________City:________________________________State:__________ IMPORTANT INFORMATION PLEASE SIGN BELOW
I hereby acknowledge that I received and read the concussion information, parental permission to play/waiver, concession stand guidelines and WCGSL jewelry policy. I certify that I understand ALL the information that has been provided to me by signing below. WCGSL PARENTAL PERMISSION TO PLAY / WAIVER I, the parent or guardians of the named applicant, give approval to my child’s participation in all activities of the Washington County Girls Softball League. I assume all risks and hazards incidental to such participation including transportation to and from all activities. I do hereby waive, release, absolve, and indemnify, and agree to hold harmless Washington County Girls Softball League and Pony Softball. The organizers, coaches, sponsors, league officials, other participants, and appointed persons transporting my child to or from program activities for any claims arising out of injury to my child incidental to such participation, except to the extent and amount covered by accident and/or liability insurance held by Washington County Girls Softball League. I further agree that in my absence, the designated league officers, and/or team coaches shall have authority to take action, as deemed necessary, to provide or render immediate medical attention to the above named applicant due to sudden illness or injury incidental to, or occurring during her participation. WCGSL/Pony Softball Jewelry Policy Players are not allowed to wear any jewelry during practices and games. This includes piercings, rings, watches, bracelets, and necklaces. Players must remove all jewelry prior to practices and/or games; this will include even new piercings. Please be aware of this a avoid problems by delaying any new piercings until after the softball season. NOTE: Medical bracelets and necklaces are not considered jewelry, but if worn must be taped to the body.
Parent/Guardian Signature:
Athlete Signature:
Date:
LEAGUE USE ONLY Payment
Cash Check # ____________
Registration Fee:_________
Amount Paid: ___________
THIS FORM MUST BE WITH MANAGER/COACH AT ALL W.C.G.S.L. ACTIVITIES.
7/17
