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Lafayette Girls Softball - Tippecanoe Softball
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Fall Player Registration Form
PLAYER INFORMATION
*
First Name:
*
Last Name:
*
Street:
*
City:
*
Zip Code:
*
Birthdate:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
1
2
3
4
5
6
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9
10
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1900
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2000
2001
2002
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2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
*
Grade:
Pre K
K
1
2
3
4
5
6
7
8
9
10
11
12
*
School:
Central Catholic
Diocese Of Lafayette
Earhart Elementary
Edgelea Elementary
Faith Christian School
Glen Acres Elementary
Lafayette Christian School
Lafayette Jefferson HS
Miami Elementary
Miller Elementary
Montessori
Murdock Elementary
Oakland Elementary
Sunnyside Intermediate
St. Lawrence
St. Boniface
St. Mary's
St. James
Tecumseh Junior High
Tippecanoe School Corp
Vinton Elementary
West Lafayette School Corp
Other
*Division is determined by the players age on January 1.
Players may move up to the next division, but cannot remain in a lower division once they reach the next age level.
*
Division:
T Ball (5-6 year olds)
Pixie (7-8 year olds)
Cadet (9-10 year olds)
Juniors (11-12 year olds)
Minors (13-15 year olds)
PARENT / GUARDIAN / EMERGENCY CONTACT
Parent 1
*
First Name:
*
Last Name:
*
Email - Use to send confirmation:
*
Cell-Primary Phone:
Parent 2
First Name:
Last Name:
E-mail Address - Use to send confirmation:
Cell - Primary Phone:
UNIFORM INFORMATION
Uniforms are supplied by The Athlete and Knoy Apparel. Parents may visit their location to select the appropriate sizes.
Tball AGE 5-6
Tball Shirt Size (Ages 5-6):
Youth S
Youth M
Youth L
Youth XL
Pixie AGE 7-8
Pixie Shirt Size (Ages 7-8):
Youth S
Youth M
Youth L
Youth XL
Adult L
Pixie Short Size (Ages 7-8):
Youth S
Youth M
Youth L
Youth XL
Adult M
Adult L
Pixie Sock Size (Age 7-8):
Youth
Adult
Cadet AGE 9-10
Cadet Shirt Size (Age 9-10):
Youth S
Youth M
Youth L
Adult S
Adult M
Cadet Pant Size (Age 9-10):
Youth S
Youth M
Youth L
Youth XL
Adult S
Adult M
Adult L
Cadet Sock Size (Age 9-10):
Youth
Adult
Junior AGE 11-12
Junior Shirt Size (Age 11-12):
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Junior Pant Size (Age 11-12):
Youth M
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Junior Sock Size (Age 11-12):
Adult
Minor AGE 13-15
Minor Shirt Size (Age 13-15):
Youth L
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Minor Pant Size (Age 13-15):
Adult S
Adult M
Adult L
Adult XL
Adult XXL
Minor Sock Size (Age 13-15):
Adult
MISC
*
I also play on another softball team:
Yes
No
Current Position:
Pitcher
Catcher
Infield
Outfield
Years of Experience:
0
1-2
3-4
5-6
7-8
JUNIOR/MINOR PLAYERS ONLY (Ages 11-15)
I am willing to be an alternate for another team
SPECIAL REQUESTS
AUTHORIZATION FOR MEDICAL TREATMENT
In the event that my daughter 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 daughter. 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 daughters medical history.
MEDICAL INFORMATION
*
Insurance Carrier:
*
Relationship to Player:
*
Policy #:
WAIVER AND RELEASE FROM LIABILITY
Waiver and Release from Liability
In consideration of my daughter's involvement and participation in softball games, practices and other activities under the authority of the Lafayette Girls Softball League, her and her legal representatives, release, hold harmless and promise not to use the Lafayette Girls Softball League, 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 she may suffer as a result of her involvement and participation in such games, practices and activities. I acknowledge that the sport of softball 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 daughter and assume all inherent risks therein.
I/we agree with the above
*
HIT THE "SUBMIT FORM" BUTTON IN ORDER TO COMPLETE REGISTRATION.
* indicates required fields
SELECT FEE
$75 - T-Ball (Ages 5-6)
$100 - Pixie (Ages 7-8)
$125 - Cadet (Ages 9-10)
$150 - Junior (Ages 11-12)
$150 - Minor (Ages 13-15)
Fundraiser donation($30)