SOFTBALL

River Cities League

PLAYER REGISTRATION FORM

Player Name

Last

Street Address

Street

City/State/Zip

City

Home Phone

( )

Email Address

State

Zip

Name

( )

Email Address

Email Address

Occupation

Occupation
Yes / No

Age as of May 1st

Name
Cell Number

Are you willing to Volunteer?

PARENT/GUARDIAN #2

( )

League Age

PARENT/GUARDIAN #1
Cell Number

Birthdate

First

Are you willing to Volunteer?

Yes / No

MEDICAL INFORMATION
Emergency Contact

Name

Relationship to Player

Health Insurance Provider

Name

Phone Number

Policy No.

I/We the parent(s)/ guardian(s) of the above named
player, hereby give my/our approval to his
participation in River Cities League Summer Softball
during the current season.

I/We assume all risks incidental to the conduct of the
sporting activities of the River Cities League and
transportation to and from these activities.

I/We do further hereby release, absolve from indemnity
and hold blameless and harmless the River Cities
League, said Leagues organizers, sponsors and the
volunteers working therein, any or all of them, in case of
injury to my/our player.

I/We hereby waive all claims against the River Cities
League, said Leagues organizers, sponsors and the

volunteers working therein, any or all of them, arising in

any way from any injury suffered by my/our player.

I/We likewise release from responsibility any person
transporting my/our player to and from the activities of
the River Cities League in regard to any and all claims
arising in any way from any injury suffered by my/our
player.

I/We will furnish a birth certificate for the above player
upon request of the River Cities League.

I/We the parent(s)/guardian(s) of the above-named
player, in case of injury to my/our player in my/our
absence, hereby authorize any hospital and/or
attending physician to give any emergency medical
attention or treatment deemed medically beneficial to
my/our player.

Parent/Guardian Signature ___________________________________________________________ Date___________________

Parent/Guardian Signature ___________________________________________________________ Date___________________