For full functionality of this site it is necessary to enable JavaScript.
Welcome to the home of the
TOWN OF BROOKHAVEN FASTPITCH LEAGUES
Login
MyLeagueLineup
Administration
Login
MyLeagueLineup
Administration
°F
Welcome
About
Bulletin Board
Contact Info
Teams & Rosters
Divisions/Leagues
Teams/Rosters
Schedules
Schedules
Calendar
Scorers
Directions
Results
Game Results
Standings
Forms
Handouts
More
Search
Pages
Pages
Login
MyLeagueLineup
Administration
Subscribe to our Newsletter
2024 Summer League Coach/Asst Coach Registration Form
COACH INFORMATION
COACH WAIVER INFORMATION FORM (A COACH IS NOT LEGALLY REGISTERED UNTIL THIS FORM IS FILED ONLINE)
*
Team Name:
*
TEAM AGE GROUP:
*
First Name:
*
Last Name:
*
Street:
*
City:
*
State:
*
Zip Code:
*
Email:
*
I,:
hereby wish to register, as a coach, for the 2024 Summer League. By signing this form, I subject myself to the rules and regulations governing play in the Town of Brookhaven Youth Fastpitch Program. Violations of these rules and regulations may result in disciplinary action against me.
*
ELECTRONIC SIGNATURE-COACH:
WAIVER AND LIABILITY RELEASE
*
I,:
hereby authorize and approve my participation in the TOWN OF BROOKHAVEN SUMMER LEAGUE. I know of no physical conditions or illnesses which would interfere with or prevent my participation in this activity. I verify that the information listed on this registration is correct and give my permission for my participation.
The undersigned hereby assumes all risks in the performance of YOUTH FASTPITCH IN THE TOWN OF BROOKHAVEN and undertakes complete responsibility for all acts undertaken by the undersigned in connection with the event on the TOWN OF BROOKHAVEN PREMESIS/PROPERTY located on the grounds of TOWN OF BROOKHAVEN FIELDS during the period of June 1, 2024 thru December 31, 2024.The undersigned further agrees to save harmless the TOWN OF BROOKHAVEN, it's officers, agents, servants, employees and enumerated volunteers, from any and all liability for any personal injuries or property damages suffered.
As a participant in the program organized and directed under the auspices of the Department of Parks, Recreation, Sports and Cultural Resources of the Town of Brookhaven, I understand that the Town of Brookhaven has not undertaken to provide any medical coverage through insurance or any other means for any injury I may suffer as a result of such participation and that I personally assume all risks of injury to myself and any medical costs related thereto. The undersigned further agrees to hold the TOWN OF BROOKHAVEN harmless from any claims made by any person for any loss, damage or injury resulting from or arising out of any acts or omissions of the undersigned or any other person acting on behalf of the undersigned, with regards to or in connection with the event.
*
ELECTRONIC SIGNATURE:
* indicates required fields