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Rochelle Park Royals Travel Team 10U
PLAYER INFORMATION
*
First Name:
*
Last Name:
Street:
City:
State:
Zip Code:
Home Phone:
*
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
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
*
Email:
Gender:
M
F
School Attending:
*
Grade:
K
1
2
3
4
5
6
7
8
9
10
11
12
UNIFORM SIZE
*
Shirt:
YS
YM
YL
AS
AM
AL
*
Pants:
YS
YM
YL
AS
AM
AL
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
In case of emergency I/we hereby authorize emergency treatment and/or care of the above participant at any hospital.
*
Emergency Contact:
*
Phone:
Relationship to Player:
Insurance Carrier:
Policy #:
Does the participant have a history of illness or allergies?:
No
Yes
If yes, please describe::
Does the participant take medication?:
No
Yes
If yes, please list medications:
BE A PART OF THE PROGRAM
I would like to volunteer as a:
Coach
Team Manager
Executive Board Member
Concussion Information
RP Baseball Concussion Protocol: Our Return to Play Policy requires that any player who has sustained a head injury or who is suspected of having sustained a head injury to: visit a licensed health care professional for evaluation and clearance AND sign a head injury awareness sheet before returning to practice or game play. Concussion awareness educational material can be found at http://www.cdc.gov/headsup/youthsports/index.html and a fact sheet for parents can be downloaded at http://www.cdc.gov/headsup/pdfs/custom/headsupconcussion_fact_sheet_for_parents.pdf
Please be advised that there are new bat rules in 2018. Please visit https://USABat.com for the approved bat list.
WAIVER INFORMATION
As the parent or legal guardian of the child named below, I hereby give my full consent and approval for my child to participate as team member in the sport designated above.
I understand that there are certain risks of injury inherent in the practice and play of this sport, as well as in traveling and other related activities incidental to my child's participation, and I am willing to assume these risks on behalf of my child. I hereby certify that my child is fully capable of participating in the designated sport and that my child is healthy and has no physical of mental disabilities of infirmities that would restrict full participation in these activities except as listed above.
In addition to giving my full consent for my child's participation, I do hereby waive, release and hold harmless Rochelle Park Baseball Assoc., its officers, coaches, sponsors, supervisors and representatives, for any injury that may be suffered to my child in the normal course of participation in the designated sport and the activities incidental thereto, whether the result of negligence or any other cause.
I/we agree with the above
*
Online Registration Requires Payment
To complete registration select fee below
* indicates required fields
SELECT FEE
$149 - Travel Team Fee