SEMMES GIRLS SOFTBALL REGISTRATION FORM

CHECK ONE: ( ) TBALL/6U ( ) 8U ( ) 10U ( ) 12U ( ) HIGH SCHOOL

PLAYERS LAST NAME: PRINT CAPITAL LETTERS

DATE OF REGISTRATION:

______/_____/______

DOB: ____/____/____ AGE AS OF JANUARY 1ST CURRENT YR: ____

PLAYER INFORMATION:

PLAYER NAME: ______

(FIRST) (MI) (LAST)

PHYSICAL Street Address REQUIRED: ______

City ______State _____ Zip ______

MAILING ADDRESS: ______CITY: ______STATE: ____ ZIP: ______

JERSEY SIZE: CIRCLE ONE YOUTH: S M L XL ADULT: S M L XL 2XL
NUMBER CHOICE:(LIST3) ______
** If numbers are not listed; Semmes Girls Softball will assign players’ number – NO EXCEPTIONS! **
  • Does player have any medical problems or allergies his/her coach should know about? ______If yes, please explain: ______

* HAS PLAYER EVER PLAYED ORGANIZED SOFTBALL? ______* Has player ever PITCHED in a game? ______

  • Does player have any siblings registered with Semmes Girls Softball this season? ______

Name: ______Age division/league ______

Name: ______Age division/league ______

PARENT/GUARDIAN INFORMATION

* Mother: ______DL# ______State: ______

Phone: HOME: ______CELL: ______Text? ______

* Father: ______DL# ______State: ______

Phone: HOME: ______CELL: ______Text? ______

EMAIL ADDRESS: Mother or Father: ______

I understand that Semmes Girls Softball Association can NOT guarantee team placement unless my player is a sibling in the same age bracket. I understand that any request made for a certain team/coach will be decided among the Head coach of each team during the draft process. Once my child has been placed on a team; I understand she will NOT be transferred. If my child should quit playing; NO REFUND OF ANY MONIES PAID WILL BE RETURNED unless documented medical issue(s) are provided by a licensed Physician. Fees paid on behalf of the player will be deducted.

______

PARENT/GUARDIAN SIGNATURE DATE

SGS INSURANCE WAIVER: Semmes Girls Softball carries asupplementalaccidental insurance policy on players registered within our organization. This policy has a $250.00 deductible for each injury. The Parent/Guardian or Player will be responsible for said deductible should an injury occur to the player listed on the front of this form. By initialing below; I have been informed of this policy and accept responsibility for said deductible.

I give my permission for my child/ward to play softball as a member of Semmes Girls Softball Association. I relieve the park, association, its’ officials, coaches, managers, and sponsors of any responsibility should an injury befall myself as a spectator or my child/ward.

In the event of an injury; if I am not available and cannot be contacted via the numbers listed on the front of this form; I authorize Semmes Girls Softball Association to call for transportation by necessary organizations to the nearest hospital and have him/her treated by a Licensed Physician. I further certify that to the best of my knowledge; my child/ward has no handicap or illness that prevents him/her from participating in organized sports.

PARENT/GUARDIAN Signature: ______

PICTURE/VIDEO RELEASE: This release is for putting pictures and/or video of our Softball Players on our Semmes Girls Softball Website or Semmes Softball Facebook and/or Instagram page. The intended use is to allow others to know what our community park is about; our players.

Pictures/Videos can be displayed individually or in a group setting. I understand that photos become property of Semmes Girls Softball Association and no monies will be received for use.

PARENT/GUARDIAN SIGNATURE: ______

EMERGENCY CONTACT: Name ______Relationship: ______

PHONE: ______Home or Cell number? ______

$25.00 NSF FEE CHARGED ON ALL RETURNED CHECKS – NO EXCEPTIONS

********************************** OFFICE USE ONLY ************************************

Receipt # ______Check # ______Cash _____ CC/DC: + $5.00 _____ Reg. Fee Paid ______Balance due: ______

RECEIVED BY: ______MULTIBLE SIBLINGS: ______BIRTH CERTIFICATE: ______