Harundale Youth Sports League, Inc. Registration Form

Player Information

(□ Male □ Female)	Name	___________________________________________________________
Date of Birth ___________________			Age __________	Home Telephone _____________________
Jersey Size □ YS □ YM □ YL □ AS □ AM □ AL □ AXL □ AL2X

Parental Information

Father Name	__________________________________________________________________
Work Telephone	______________________________
Have you ever (please indicate)				Managed a Team □ Yes □ No		Coached a Team □ Yes □ No
Mother Name	__________________________________________________________________
Work Telephone	______________________________
Have you ever (please indicate)					Managed a Team □ Yes □ No	Coached a Team □ Yes □ No
Home Address	__________________________________________________________________
City, State, Zip Code		________________________________________________________________
Internet Address (email)			______________________________________________________________

PLAYER AGENT ONLY – Please do not write below this line______________________________

□ Baseball □ Softball	□ Fall Baseball		□ Soccer		□ Fall Soccer		□ Basketball
Division ________________________________				Team _____________________________________
Amt. Paid _____________		Receipt / Check No. _______________				Registered By ______________

Parental Waiver and Consent Authorization

As the parent or legal guardian of the child named on this form, I hereby give my full consent and approval for my child to participate as a team member in the sport designated. I also contend that all the information completed on this form is accurate and true to the best of my knowledge.

I understand that there are certain risks of injury inherent in the practice and play of this sport, as well as in traveling and other related activities incidental to my child’s participation, and I am willing to assume these risks on behalf of my child. I hereby certify that my child is fully capable of participating in the designated sport and that my child is healthy and have no physical or mental disabilities or infirmities that would restrict full participation in these activities, except as listed below.

In addition to giving my full consent for my child’s participation, I do hereby waive, release and hold harmless Harundale Youth Sports League, Inc. (HYSL, Inc.), it’s officers, coaches, sponsors, supervisors and representatives for an injury that may be suffered by my child in the normal course of participation in the designated sport and the activities incidental there to, whether the result of negligence or any other cause.

Any player that plays for HYSL, Inc. is permitted to participate in any sport for another league or team. However, the player’s first responsibility is to HYSL, Inc. If the player misses practice or games because of other league or team commitments, they will be subject to board review. There will be no recourse by either the youth or parents. School athletics will be the only exception.

REFUNDS - HYSL will withhold an amount equal to 10% of any registration fee returned at the request of any participant. All refunds will be in the form of a HYSL League check.

Please list any physical limitations (allergies, hearing, sight, etc.) _________________________________________

Signature of Guardian _______________________________

Date _____________________________