OAKVILLE SENIORS SLOW PITCH LEAGUE [OSSPL]

2017 SEASON APPLICATION

NAME: First Last / DATE OF BIRTH Day / Month / Year
ADDRESS:
E MAIL: / HOME PHONE #:
Cell #: Work #:
PREFERRED METHOD OF CONTACT: CHECK
EMAIL: PHONE: CELL: HOME: WORK:
EMERGENCY CONTACT NAME:
EMERGENCY PHONE #:
WHAT ARE YOUR PREFERRED FIELD POSITIONS TO PLAY?
1. / 2.
DO YOU HAVE ANY MEDICAL CONDITIONS THE LEAGUE EXECUTIVE OR TEAM MANAGER SHOULD BE AWARE OF? [I.E. HEART CONDITION, DIABETES, EPILEPSY, ETC]
IF YES SPECIFY:
It is recommended you discuss partaking in this activity with your physician. / IF YES, DO YOU CARRY ANY MEDICAL ALERT OR MEDICATION ON YOUR PERSON?
If yes, where is it located?
WAIVER / RELEASE & INDEMNITY -Note: This release form is a contract with legal consequences that among other things waive your right to sue the League, Team Members, Executive or Managers.
On behalf of myself, members of my family, my heirs, executors, administrators and assigns, I hereby waive all claims I may have and release, discharge and hold harmless OSSPL, its Executive, Managers, sponsors, volunteers and other players for any injury, loss or damage to my person, reputation or property howsoever caused, arising out of, or in connection with my taking part in slo-pitch activities including but not limited to participation at/in games, practices, social events and travel to and from events hosted by OSSPL. Notwithstanding that, the same may have been contributed to or occasioned by the negligence or decisions of OSSPL, its Executive, Managers, sponsors and other players. I am aware that failure to fully comply with all rules, Code of Conduct, regulations, orders, directives and policies established by OSSPL, in connection with any matter relating to my participation, may result in disciplinary action being taken against me. Such action may be in the way of suspension[s] from OSSPL and such suspension[s] may be for any duration as decided by OSSPL Executive. If my actions are deemed detrimental to OSSPL or any other participant, OSSPL may impose sanctions including but not limited to expulsion from OSSPL, cancellation of membership and/or any costs incurred as a result of our actions. Decisions made by OSSPL are not subject to appeal, nor refund of registration fees. I acknowledge and agree that OSSPL has sole discretion to determine if I have satisfactorily complied with the above written. I understand that OSSPL reserves the right to publish and use the name and photographs of any participants involved in OSSPL events. In addition, pursuant to the province’s Information and Privacy Act, I consent to the use by OSSPL of information about me for the sole purpose of OSSPL or slo-pitch related activities.
Please send this signed application along with your $100.00 registration fee before December31, 2016[later fee $120.00](No post dated checks please. Make checks payable to: OAKVILLE SENIORS SLOW PITCH LEAGUE
And forward to: EvLucenti, 376 Karen Park Crescent, Mississauga, L5A3C6
PLAYER’S SIGNATURE: / DATE: