Lafayette Girls Softball - Tippecanoe Softball - (Lafayette, IN)

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Fall Player Registration Form

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* Zip Code:

* Birthdate:

* Grade:

* School:

*Division is determined by the players age on January 1.
Players may move up to the next division, but cannot remain in a lower division once they reach the next age level.

* Division:

PARENT / GUARDIAN / EMERGENCY CONTACT

Parent 1

* First Name:

* Last Name:

* Email - Use to send confirmation:

* Cell-Primary Phone:

Parent 2

First Name:

Last Name:

E-mail Address - Use to send confirmation:

Cell - Primary Phone:

UNIFORM INFORMATION

Uniforms are supplied by The Athlete and Knoy Apparel. Parents may visit their location to select the appropriate sizes.

Tball AGE 5-6

Tball Shirt Size (Ages 5-6):

Pixie AGE 7-8

Pixie Shirt Size (Ages 7-8):

Pixie Short Size (Ages 7-8):

Pixie Sock Size (Age 7-8):

Cadet AGE 9-10

Cadet Shirt Size (Age 9-10):

Cadet Pant Size (Age 9-10):

Cadet Sock Size (Age 9-10):

Junior AGE 11-12

Junior Shirt Size (Age 11-12):

Junior Pant Size (Age 11-12):

Junior Sock Size (Age 11-12):

Minor AGE 13-15

Minor Shirt Size (Age 13-15):

Minor Pant Size (Age 13-15):

Minor Sock Size (Age 13-15):

MISC

* I also play on another softball team:

Current Position:

Years of Experience:

JUNIOR/MINOR PLAYERS ONLY (Ages 11-15)

I am willing to be an alternate for another team

SPECIAL REQUESTS

AUTHORIZATION FOR MEDICAL TREATMENT

In the event that my daughter shall require any medical or dental treatment and it is not possible or reasonable to contact me in person or by telephone, I authorize league officials to consent to any and all medical, hospital or dental care and treatment which may be deemed reasonable and necessary by any licensed physician or dentist for the health and welfare of my daughter. This authorization does not cover major surgery, unless the medical opinion of at least two physicians concurring that such surgery is necessary is obtained prior to the procedure. I authorize the release of the following information to any physician, hospital or other health care provider who may not have access to my daughters medical history.

MEDICAL INFORMATION

* Insurance Carrier:

* Relationship to Player:

* Policy #:

WAIVER AND RELEASE FROM LIABILITY

Waiver and Release from Liability
In consideration of my daughter's involvement and participation in softball games, practices and other activities under the authority of the Lafayette Girls Softball League, her and her legal representatives, release, hold harmless and promise not to use the Lafayette Girls Softball League, its officers,directors, coaches, officials, employees, umpire, and agents or the ASA with respect to or in connection with any claim for injury or damage to person or property which she may suffer as a result of her involvement and participation in such games, practices and activities. I acknowledge that the sport of softball and the physical activities associated therewith present the risk of serious physical injury, including paralysis and death, and with such knowledge, I consent to such involvement and participation by my daughter and assume all inherent risks therein.

I/we agree with the above *

HIT THE "SUBMIT FORM" BUTTON IN ORDER TO COMPLETE REGISTRATION.

* indicates required fields

Fundraiser donation($30)