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LADY BRAWLERS TRYOUTS FORM

* PLAYERS NAME:

* PLAYERS ADDRESS:

* Birthdate:

Grade:

Previous Travel Teams:

* YEARS OF TRAVEL BALL EXPIERENCE:

* Parent's Name:

* Phone #:

* EMail:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

Relationship to Player:

Policy #:

I, the undersigned, by signing below certify that all information provided on this registration form is accurate and complete. In the event that I cannot be reached in an emergency, accident or injury, which occurs while above named minor is participating in any activity of GC Lady Brawlers, I hereby give permission for the representatives of GC Lady Brawlers to secure whatever medical or hospital care necessary, and I agree to be financially responsible for such care. I hold GC Lady Brawlers and the coaches, officers and representatives of the organization harmless and indemnify them against any liability, loss or injury incurred while participating in the activities associated with the program. I agree to abide by the rules and regulations of the GC Lady Brawlers

I/we agree with the above *

* indicates required fields

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LADY BRAWLERS TRYOUTS FORM