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Regform 09

This document is a registration form for the Ancaster Little League 2009 season. It requests player information like name, address, birthdate, medical information, and emergency contacts. It also asks for a parent signature consenting to the child's participation and acknowledging the risks involved. Payment information is recorded at the bottom. The form provides the divisions and age groups available for both boys and girls baseball/softball. It also asks if the parent would like to volunteer and in what capacity. Refund and late fee policies are stated as being posted on the league website.

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28 views

Regform 09

This document is a registration form for the Ancaster Little League 2009 season. It requests player information like name, address, birthdate, medical information, and emergency contacts. It also asks for a parent signature consenting to the child's participation and acknowledging the risks involved. Payment information is recorded at the bottom. The form provides the divisions and age groups available for both boys and girls baseball/softball. It also asks if the parent would like to volunteer and in what capacity. Refund and late fee policies are stated as being posted on the league website.

Uploaded by

fcf98
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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ANCASTER LITTLE LEAGUE 2009 REGISTRATION & OFFICIAL RECEIPT

FIDDLERS GREEN POSTAL OUTLET, P.O . BOX 81321, ANCASTER ON L9G 4X2 TELEPHONE 905 648-4244
WEBSITES: WWW.ANCASTERBASEBALL.ORG & WWW.ANCASTERFASTPITCH .CA EMAIL: [email protected]

(PLEASE PRINT CLEARLY IN BLOCK LETTERS)


PLAYER INFORMATION:
Name: _____________________________________________________________________ Male_____ Female_____
Address__________________________________City_________________________Postal Code__________________
Telephone: 1)______________________2)_______________________Birth date: M________ D_______ Y__________
E-mail: _____________________________________________________
PLEASE CHECK ONE ONLY:

Boys & Girls


X Age Group X Girls Division Age Group
Division
Blastball 4-5 Girls Softball – Mite/Atom 9 -10
T-Ball 6-7 Girls Softball - Squirt 11-12
Rookie Ball 7-8 Girls Softball – Novice/Pee Wee 13 - 14
LL Minor Baseball 9 – 10 Girls Softball - Bantam 15 - 16
State Age on April 30
LL Major Baseball 11 - 12 Girls Softball - Midget 17 – 19
State Age on April 30
OBA - Bantam Boys 13 – 15 OBA Players Birth Registration #
OBA – Midget Boys 16 – 19 #________________________________

VOLUNTEERS/FUNDRAISER: Please check one below:


Team Manager_____ Assistant Coach_____ League Auxiliary_____ Grounds_____ Tournaments____ Fundraising____
MEDICAL INFORMATION:
Allergies: _________________________________________________________________________________________
Other Health Concerns: _____________________________________________________________________________

EMERGENCY CONTACTS:
Parent/Guardian: ________________________________ Telephone: ____________________Relationship___________
Alternate: ________________________________Telephone: _____________________Relationship________________

I understand that if my child needs emergency medical treatment, the coach or other team representative will attempt to
contact the alternative emergency contact or me. In our absence I give permission to the coach or other team / league
representative to seek and obtain any emergency care that is required.
Parent/Guardian Signature X____________________________________ Date _________________________________
PARENT/GUARDIAN INFORMATION: As the parent/guardian of the above mentioned minor, I hereby give my consent to
his/her participation in any and all activities of Ancaster Little League for the current season. I acknowledge that
participation involves risk of injury, minor or serious, including the possibility of permanent disability. Injury may result from
the actions of the minor named above, the actions or inactions of others, or a combination of both. I understand that this
activity is governed by rules and regulations that are designed for the safety and protection of participants. I hereby
undertake to assure that the named minor understands and abides by all such rules and regulations. I also understand
that this activity requires a minimum of fitness for safe participation.
Signature X________________________ of Parent/Guardian ________________________________ Date___________
Print Name in Full

OFFICE USE ONLY REFUND/LATE FEE POLICIES


& ALL OTHER INFORMATION
Amount Paid: $_____________ Cheque #_____ _____ or Cash POSTED ON WEBSITE
Authorized Executive Signature X____________________________________________ Dated ____________________

White Copy – Registrar ** Yellow Copy – Convener ** Pink Copy – Parent**

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