Vallejo Hurricanes

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2017 10U Fall Ball Registration Form

* Player Name:

* Last Name:

* City:

* Street:

* State:

* Zip Code:

* Cell Phone:

* Birthdate:

* Email:

* Gender:

* Grade:

PARENTS/GUARDIANS

* Firstname:

* Lastname:

* EMail:

* Home Phone:

* Cell Phone Mom::

* Cell Phone Dad::

MEDICAL/EMERGENCY CONTACT INFO.

* Emergency Contact:

* Phone:

* Relationship to Player:

* Policy#:

* Insurance Carrier:

PLAYER INFO.

* High School:

* Graduating Year:

WAIVER INFORMATION

I understand that participation in softball may result in serious injury and that protective equipment does not prevent all injuries to players. I hereby release from any and all liability, and agree to hold harmless, any and all individuals or entities associated with or involved in, the Vallejo PAL Hurricanes and the affiliated Softball associations including but not limited to the organizers, Board of Directors, managers, coaches, sponsors, supervisors and other volunteer and any paid participants. Also included in this release are any and all hosting locations, facilities or entities affiliated with any Travel
Softball Activities. I knowingly and voluntarily waive any claim against the aforementioned that may arise out of any accident, injury, illness or death to my child that may occur during her participation in softball activities including, but not limited to tryouts, games, practices, meetings, team parties,
ceremonies, travel and tournaments, whether caused by negligence or any other cause.
I certify my child is in good physical condition and able to participate in any physical Softball related activity.
I certify that the information contained on my child's tryout waiver form is accurate.

I/we agree with the above *

* indicates required fields

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2017 10U Fall Ball Registration Form