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Single Player Registration 5-14 Years Old (Fall or Spring League)

Player Information

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

* Home Phone:

* Birthdate:

* E-Mail:

Gender:

Grade:

New Registrant (First time playing in league?)

Team Name (If player is returning to a team):

Participants are required to submit a photocopy of their birth certificate,
passport or government issued ID to certify their birth date.

*ORIGINALS WILL NOT BE ACCEPTED*

PARENT/GUARDIAN #1

* First Name:

* Last Name:

E-Mail:

Home Phone:

Work Phone:

* Cell Phone:

PARENT/GUARDIAN #2

First Name:

Last Name:

E-Mail:

Home Phone:

Work Phone:

* Cell Phone:

MEDICAL/ EMERGENCY CONTACT INFORMATION

* Emergency Contact:

* Phone:

* Relationship To Player:

Insurance Carrier:

Policy #:

I the parent/guardian of the registrant, a minor, agree that I and the registrant will abide by the rules of the GBSL Baseball & Softball League and its affiliated organizations and sponsors including, but not limited to, mandatory participation in any fundraising activities. Failure to participate in all league activities may result in the player becoming ineligible for any awards and/or post season participation (i.e. tournaments). Recognizing the possibility of physical injury associated with youth league sports and in consideration for the GBSL Baseball & Softball league accepting the registrant for its sports programs and activities, I hereby release, discharge and/or otherwise indemnify the GBSL Baseball & Softball league ,its affiliated organizations and sponsors, their employees and associated personnel, including the owners of fields and facilities utilized for the programs, against any claims by or on behalf of the registrant as a result of the registrants participants in the programs and/or being transported to or from the same, which transportation I hereby authorize. It is further agreed that all equipment and uniforms supplied by shall remain the property of GBSL Baseball and Softball league said organization, unless agreed upon by said organization and shall be properly cared for by the applicant and shall be returned in same condition as issued to applicant except for normal wear and tear.

I/ We agree with the above statement. *

CONSENT FOR MEDICAL TREATMENT (MINOR)
As the parent or legal guardian of the above-named player, I hereby give my consent for emergency medical care prescribed by a duly licensed doctor of medicine or doctor of dentistry. This care may be given under whatever conditions are necessary to preserve the life, limb, or well-being of my dependent.

I/ We agree with the above statement. *

Parent Comments/ Questions:

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IMPORTANT: Online Payment with credit cards is not active for this form

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Single Player Registration 5-14 Years Old (Fall or Spring League)