Lafayette Girls Softball - Tippecanoe Softball - (Lafayette, IN)

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LGS Development Teams

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Home Phone:

* Grade:

* School:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail - Use to send confirmation:

* Home Phone:

* Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

UNIFORM INFORMATION

Uniforms will be purchased by the Lafayette Warriors Baseball organization. There will be an opportunity to try on the uniforms and make changes in sizes before the uniforms are ordered.

* Shirt Size:

* Short Size:

* Sock Size:

AUTHORIZATION FOR MEDICAL TREATMENT

In the event that my son shall require any medical or dental treatment and it is not possible or reasonable to contact me in person or by telephone, I authorize league officials to consent to any and all medical, hospital or dental care and treatment which may be deemed reasonable and necessary by any licensed physician or dentist for the health and welfare of my son. This authorization does not cover major surgery, unless the medical opinion of at least two physicians concurring that such surgery is necessary is obtained prior to the procedure. I authorize the release of the following information to any physician, hospital or other health care provider who may not have access to my sons medical history.

I/we agree with the above

MEDICAL/EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship to Player:

* Insurance Carrier:

* Policy #:

WAIVER AND RELEASE FROM LIABILITY

Waiver and Release from Liability
In consideration of my son's involvement and participation in baseball games, practices and other activities under the authority of the Lafayette Girls Softball and Lafayette Warriors Baseball, he and his legal representatives, release, hold harmless and promise not to use the Lafayette Girls Softball League, Lafayette Warriors Baseball, its officers,directors, coaches, officials, employees, umpire, and agents or the ASA with respect to or in connection with any claim for injury or damage to person or property which he may suffer as a result of his involvement and participation in such games, practices and activities. I acknowledge that the sport of baseball and the physical activities associated therewith present the risk of serious physical injury, including paralysis and death, and with such knowledge, I consent to such involvement and participation by my son and assume all inherent risks therein.

I/we agree with the above *

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