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2025/26 TOB BASEBALL INDIVIDUAL PLAYER AGREEMENT/WAIVER FORM

PLAYER INFORMATION
Youth Player Waiver Information Form (A player is not legally registered until this form is filed online).

* Team Name:

* Age Group(s):

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Birthdate:

* I,:

hereby wish to register in the Brookhaven Town Youth Baseball Program. By signing this form, I subject myself to the rules and regulations governing play in the Town of Brookhaven Youth Baseball Program. Violations of these rules and regulations may result in disciplinary action against me.

* ELECTRONIC PLAYER SIGNATURE:

Parent/Guardian Permission

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip:

* EMail:

WAIVER AND LIABILITY RELEASE

* I,:

* ELECTRONIC PARENT SIGNATURE:

* indicates required fields

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