Gladstone Softball Association - (Gladstone, OR)

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Pickup Player Registration Form

Player Info

* Players First Name:

* Players Last Name:

* Date Of birth:

* Age on September 1, 2023:

* Street Address:

* City:

* Zip Code:

* Players Grade in school for upcoming year:

* Age Level Requested:

* Coaches Name and Team Name:

* We Played Softball in Spring 2024:

1st Parent/Guardian Info

* First Name:

* Last Name:

* Street Address:

* City:

* Zip Code:

* Phone # 1:

Phone # 2:

* Email:

2nd Parent/Guardian Info

First Name:

Last Name:

Street Address:

City:

State:

Zip Code:

Phone # 1:

Phone # 2:

Email:

Medical/Emergency Info

* Emergency Contact:

* 1st Phone:

2nd Phone:

* Relationship To Player:

* Does player have any medical issues? Even something minor that the coaches should be aware of.:

If you answered yes to previous question please explain below:

* Parents full name filling out this form- this will be used as a signature:

* indicates required fields