Wells Athletic Association

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2023 Baseball Registration

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Home Phone:

* Birthdate:

* Age as of 4/30/23:

* Email:

* Gender:

* Elementary School District:

* Grade:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

* Home Phone:

* Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

* Insurance Carrier:

Policy #:

I/we, the parents or legal guardians of the above candidate for a position on the Wells Baseball team, hereby give my/our approval to her participation in any and all league activities.

I/we assume all risks and hazards incidental to such participation including transportation to and from the activities and I/we do hereby waive, release, absolve, indemnify and agree to hold harmless Wells Athletic Association, Inc., the organizers, sponsors, supervisors, participants and persons transporting my/our child.

I/we have read the Code of Conduct and understand said document.

I/we agree to return all uniforms and other equipment issued to my/our child in as good a condition as when we received, except for normal wear and tear.

I/we will furnish a birth certificate or other proof of birth of the above named candidate at the initial sign in.

I/we will participate in the league’s fund raising projects, and see that all money and unsold merchandise is returned to the designated individuals when due.

Signature(s) signify understanding of the agreement to all dues, fees and duties associated with/for Wells Baseball. All returned checks will be charged and fees incurred by said association.

I/we will provide proper Baseball equipment (baseball shoes, glove) for our child as required by said league rules (Chesterfield Baseball Club).

PLEDGE: I/We as parent(s) or legal guardian(s) will abide and support all rules, guidelines, and standards as set forth by the Chesterfield Baseball Club (CBC), and Chesterfield County. I/We understand that any violation committed by me/us will result in my/our suspension and preclude me/us from attending future league games/functions.

*** Insert your waiver information here ***

I/we agree with the above *

* indicates required fields

Fundraiser - WAA Donation Thank you!($10)

Fundraiser - WAA Donation Thank you!($15)

Fundraiser - WAA Donation Thank you!($25)

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2023 Baseball Registration