Frederick Rangers Baseball Club

Spring 2010 Registration Form

Welcome to the Frederick Rangers Baseball Club. Please print clearly, sign the form and turn it in to your team’s manager.

Player Information:

Player Name (First, MI, Last)______________________________________________________

Street Address_________________________________________________________________

City, State and ZIP______________________________________________________________

Email address__________________________________________________________________

Birth Date_____________________________________________________________________

Age (as of April 30, 2010)_________________________________________________________

Team: 14U__________ 15U__________

Parent/Guardian – Name and Phone_______________________________________________

Emergency Contact - Name and Phone_____________________________________________

CONSENT FOR PARTICIPATION AND RELEASE OF LIABILITY (PLEASE READ AND SIGN)

I/We, the undersigned parents and/or legal guardian of________________________________,

the named child registered for a roster position on the Frederick Rangers Baseball Club of Frederick, Maryland, do hereby acknowledge and recognize the following:

1. Give our approval to participate in any and all club activities for the 2010 season.

2. I/We consent to my/our child’s participation in the baseball club with full knowledge of all risks and possible medical injuries which could occur from playing in club and assume all risks and hazards incidental to such participation, including but not limited to: transportation to and from activities and I/We herby waive, release, absolve, indemnify and agree to hold harmless the Frederick Rangers Baseball Club, the chartering organization, the organizers, sponsors, participants and persons transporting my/our child to and from activities for any claim arising out of injury to my/our child, whether the results of negligence or from any other cause, except to the extent in the amount covered by accident and liability insurance.

3. I/We understand that the insurance carried by the Frederick Rangers Baseball Club covers only the amount that is not paid by my/our insurance carrier.

4. That I/We hereby acknowledge that my/our child is in excellent physical health and that I/We know of no reason whatsoever that my/our child’s physical condition would prevent him/her from participating in all activities associated with the Frederick Rangers Baseball Club.

5. I/We agree to return, upon request, the uniform and other equipment issued to my/our child in as good as condition as when issued except for normal wear and tear.

6. I/We have furnished a certified birth certificate for my/our child to my/our child’s team manager.

Guardian / Father Signature and Date___________________________________

Guardian / Mother Signature and Date__________________________________