Roseland Recreation Department

140 Eagle Rock Avenue – 973/403-6822 –

Mayor John Duthie

2016 Spring Youth Baseball and Softball Leagues for Roseland Boys and Girls

Projected start: Practice (Grades 1 - 8 Baseball and Softball – week of 3/28) - Opening Day 4/23

Leagues: A/West Essex Baseball (Grades 7 - 8) A/ West Essex Softball (Grades 7- 8)

B/West Essex Baseball (Grades 5 - 6) B/ West Essex Softball (Grades 5 - 6)

C/West Essex Baseball (Grades 3 - 4) C/ West Essex Softball (Grades 3 - 4)

D/West Essex Baseball (Grades 1 - 2) D/West Essex Softball League (Grade1 - 2)

Registrations: Mail to or Walk into: 140 Eagle Rock Avenue, Monday through Friday from 8:30 a.m. – 4:30 p.m.

Fee: $100.00 (A, B, C & D) – Make checks payable to: Borough of Roseland

Deadline Friday, February 12, 2016 (first come/first served)

After the deadline, all registrants will be assessed a $15 late fee and will be added if space is available.

(If you drop out of Recreation Baseball/Softball, there is a $25 administrative fee on all refunds)

IMPORTANT - all registered players must buy their own athletic white baseball/softball pants.

Uniform Return Policy: Failure to return the shirt within two weeks after the season will result in a suspension from all recreation privileges.

If the shirt is damaged or lost, there will be a $30.00 fee assessed for the replacement value.

2016 Spring Youth Baseball /Softball Detach Here Office Use Only!

One form per participant ______

Cash Check No. Amt. Date Rec’d.

Player’s Name ______Email Address______

Address______/______/______/______

Street / P.O. Box Town State Zip

Home Phone ______Emergency Phone ______Cell Phone ______

Birth Date ______Age ______Grade ______Sex ______CIRCLE ONE: BASEBALL / SOFTBALL

Did your child play last year? Yes ___ No ___ League Last Year? ______Does your child play another spring sport? Yes ____ No ____

Does your son/daughter have any health condition(s) the Recreation Department Staff should know about? No ______

Yes ______Explain: ______

Child Photo / Video / Release Form

I grant permission for the Borough of Roseland, Roseland, New Jersey to use photograph(s)/moving image(s) of my child participating in Borough programs and/or activities for promotional purposes. I understand that photographs or recordings may be utilized by the Borough at its discretion for materials including, but not limited to: newsletters, brochures, television, video tape and flyers. Photographs sent to the local newspaper may have names noted. There will be no valuable consideration paid as a result of this activity. Yes ___ No ___

PARTICIPANT WAIVER OF CLAIM FORM: As partial consideration for the Borough of Roseland providing ______(“Participant”) with the opportunity to participate in Baseball and / or Softball I, ______, as parent or guardian of Participant, on his or her behalf and on my own behalf and that of my spouse or partner, agree to hereby 1) acknowledge that there are foreseeable and unknown risks inherent in participation in the Program, 2) release, indemnify and hold harmless the Borough of Roseland, it officials, departments, employees, volunteers, contractors, insurers, including the NJIIF and the Borough of Roseland, its owners, employees, volunteers and subcontractors from and against all claims, losses, costs an damages arising from Participant participation in the Program, and 3) agree that for any loss or damage suffered by Participant will be turned over to parent / guardian’s insurance company. I also represent that the Participant has been cleared by his/her physician to participate in the Program. If a medical emergency should arise and the parent / guardian cannot be reached immediately at the home phone # (______), at the work phone # (______), at the emergency phone # (______) or via the cell phone # (______), I, parent or guardian, hereby grant medical personnel to take whatever means he or she deems necessary to safeguard the welfare of the Participant.

Note: The Recreation Department will not honor requests to be placed on a Specific Team.

Print Name ______Signature______Date______

Parental Assistance: I am interested in:

Head Coach ______Asst. Coach______Sponsorship ______

Name ______Home Phone ______Work Phone ______

Cell Phone ______E-mail Address ______Fax Number ______

For more program information, turn to channel 35/46, check out our website at www.roselandnj.org or look in “The Progress Newspaper