For full functionality of this site it is necessary to enable JavaScript.
WELCOME TO THE Official HOME OF THE
The Official Home of the Plainedge Youth Baseball League
Login
MyLeagueLineup
Administration
Login
MyLeagueLineup
Administration
°F
Home
About
Divisions
Photo Albums
Board
Links
Sponsors
Teams & Rosters
Divisions/Teams
Teams/Rosters
Schedules
Schedules
Calendar
Officials/Umpires
Fields
Results
Standings
Forms
Registration/Sponsorship
Handouts
More
Coupons
Pages
2021 Moms Softball Schedule
Tournament Insurance Forms
Tax ID Form
Login
MyLeagueLineup
Administration
Subscribe to our Newsletter
2024 Moms Softball Registration
It's Your Turn to Take the Field Moms!
PYBL is excited to bring back Moms Softball once again. Please complete this form and click the "submit form" button at the bottom of the page.
Each player registers individually. If you are a team organizer or there are other Moms you would like to request to be on a team with, please list their names in the space provided below. In turn, those players should list your name on their registration form as well. Teams must have a minimum of 10 players. If your group does not have 10 players, PYBL will place additional players needed to complete your squad. Have fun, good luck, and we'll be cheering for you all!
*If for any reason this program is canceled, all Moms Softball registrants will receive a 100% REFUND.
PLAYER INFORMATION
*
First Name:
*
Last Name:
*
E-Mail:
*
Primary Phone:
Secondary Phone:
*
Street:
*
City:
*
State:
*
Zip Code:
*
Birthdate:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
1917
1918
1919
1920
1921
1922
1923
1924
1925
1926
1927
1928
1929
1930
1931
1932
1933
1934
1935
1936
1937
1938
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
YES! I'm interested in being a team Manager or Coach
E-Mail:
Phone:
*
Competitive or Friendly:
Competitive
Friendly
Please list a team organizer, coach, or other Moms you would like to be on a team with:
Comments:
MEDICAL/EMERGENCY CONTACT INFORMATION
*
Emergency Contact:
*
Phone:
*
Relationship to Player:
WAIVER INFORMATION:O2 Insurance Services – CA License # 0791300
Waiver of Liability, Release For and in consideration of the undersigned participant's registration with PYBL and being allowed to participate in events and member activities, participant and the parent(s) or legal guardian(s) of participant waive, release and relinquish any and all claims for liability and cause(s) of action, including for personal injury, property damage or wrongful death occurring to participant or participant’s parent(s) or legal guardian(s) arising out of participation in events, or sports, and/or activities incidental thereto, whenever or however they occur and for such period said activities may continue, and by this agreement any such claims, rights, and causes of action that participant and/or participant's parent(s) or legal guardian(s) may have are hereby waived, released and relinquished, and participant and participant’s parent(s)/guardian(s) do so on behalf of their heirs, executors, administrators and assigns.
Participant and participant's parent(s)/guardian(s) acknowledge, understand and assume all risks relating to events or sports participation and activities incidental thereto, and understand that activities incidental thereto involve risks to participant's and participant's parent('s)/guardian('s) person including bodily injury, partial or total disability, paralysis and death, and damages which may arise there from and that we have full knowledge of said risks. These risks and dangers may be caused by the negligence of the participant, participant's parent(s)/guardian(s)or the negligence of others, including the organization, its affiliates, members, event hosts, other participants, other parents and legal guardians, coaches, officials, sponsors, advertisers, owners and operators of the premises used to conduct any event and each of them, their officers, directors, agents and employees (collectively, "releasees"), and include risks arising from the conditions and use of facilities and related premises. I/We further acknowledge that there may be risks and dangers not known to us or not reasonably foreseeable at this time. Participant and participant's parent(s)/guardian(s) acknowledge, understand and assume the risks, if any, arising from the conditions and use of facilities and related premises, whether as a participant or a spectator, including without limitation, the risks involved with participating in the Organization’s activities. Participant and participant's parent(s)/guardian(s) further acknowledge and understand that included within the scope of this waiver and release is any cause of action (including any cause of action based on negligence) arising from the performance, or failure to perform, maintenance, inspection, supervision or control of said areas and for the failure to warn of dangerous conditions existing at said facilities, for negligent selection of certain releasees, or negligent supervision or instruction by releasees. Participant and participant's parent(s)/guardian(s) acknowledge, understand The Organization reserves the right to photograph facilities, activities and program participants for potential future use. All photos remain the property of the Organization and may be used for publicity and promotional services. Consent to Medical Treatment of Minor: I hereby give my consent to have the above applicant treated by a physician or surgeon in case of sudden illness or injury while participating in the above event. It is understood that the Organization provides no medical insurance for such treatment under its liability insurance coverage. Medical benefits for such treatments/injuries may be provided with proof of medical coverage purchased through the Organization. The location of the activity or the nature of the illness or injury may require the use of emergency medical personnel. Participant and participant's parent(s)/guardian(s) agree if any claim for personal injury or wrongful death is commenced against releasees, he/she shall defend, indemnify and save harmless from any and all claims or causes of action by whomever or wherever made or presented for his/her personal injuries, property damage or wrongful death. Participant and participant's parent(s)/guardian(s) acknowledge that they have been provided and have read the above paragraphs and have not relied upon any representations of releasees, that they are fully advised of the potential dangers and risks and understand these waivers and releases are necessary to allow the activities of the Organization to exist in its present form.
Check the box as a your digital signature
I/we agree with the above
*
*
Name:
* indicates required fields
Moms Softball Friendly Registration (a 4% Online Processing Fee will be added at checkout)($57)
Moms Softball Competitive Registration (a 4% Online Processing Fee will be added at checkout)($57)