Registration – Single « Pajaro Valley Girls Softball

Player Name *

Age *

(Player's Age on September 1st)

Birthdate *

Lives With:

Mother
Father
Other

Occupation - Father

Email Address - Father

Shirt Size

(Please specify Youth or Adult size)

Special Remarks

Occupation - Mother

Email Address - Mother

Father's Name *

Father's Full Address

Mother's Phone #

Other Name

Other Full Address

Father's Phone #

Mother's Name *

Mother's Full Address

Other Phone #

Name of Player *

Phone Number *

Full Address *

Family Doctor's Name & Phone Number

Relevant past Illness, Injuries, or Allergies (if any)

Insurance Company

Policy Number: *

Comments:

In my opinion, *

is physically able to participate in this USA Softball League and has my permission to do so. I Understand that participation in softball may result in serious injury to my/our child. Protection equipment does not prevent all injury to players. In case of emergency: If Family Physician cannot be reached, I hereby authorize the above named player to be treated by another physician who is available. Also, this USA League has authorization to take the player to the nearest facility for treatment. Signed, *

Signature

Relationship to player, and today's Date *

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Softball Links

Registration – Single