Beacon Xtreme Fastpitch Softball

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2022 / 2023 ONLINE TRYOUT FORM

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

Home Phone:

* Birthdate:

* Age Group:

Grade:

Positions Played

* Primary Position:

* Secondary Position:

* Additional Position:

Previous Travel Experience:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

Home Phone:

Work Phone:

* Cell Phone:

* Parent, Guardian or Adult E-mail:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

WAIVER INFORMATION

I/We, the parent/guardian of the above mentioned minor, hereby consent authorization for the treatment for any medical emergency which might occur during participation in the Beacon Xtreme/Beacon Girls Softball program.
I also consent to the aforementioned minor to participate in the Beacon Xtreme/Beacon Girls Softball program, and understand that injuries are a part of the sport. I hereby wave my right to hold Beacon Xtreme and/or its coaches liable for any injury my daughter may incur.
Proof of Birth must be supplied to the organization.
Proof must be a Birth Certificate, Baptismal Record, or School Record.

I/we agree with the above *

* indicates required fields

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2022 / 2023 ONLINE TRYOUT FORM