CENTRAL STATE SPIKES

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Online Player Registration Form

For Which Spikes Team Would You Like To Be Considered For?:

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Birthdate:

* Player's Age As Of April 30, 2016:

Player's Grade In Fall 2015:

Player's Future High School:

Player's Height:

Player's Weight:

Uniform Size:

Best Position:

I understand Spikes Baseball practice/games/events takes priority above any Little League or Other Travel Team player may compete for in 2016.

PARENT/GUARDIAN #1

Firstname:

Lastname:

* EMail:

Home Phone:

Work Phone:

Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

* Email:

Home Phone:

Work Phone:

Cell Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

I, the parent/guardian, give my permission for any emergency treatment necessary. I authorize any hospital and/or physician to perform emergency treatment for injuries resulting from any Central State Spikes function, including travel to and from said function. This release expires after all schedule games for the Central State Spikes in 2013.

Agree With Terms Of Medical Release:

PARENT/GUARDIAN AGREEMENT
I, the parent/guardian of the above named applicant to the Central State Spikes Travel Baseball Club, hereby give my permission to said applicant's participation in any and all activities during the current season. I assume all risks and hazards incidental to such participation including transportation to and from activities; and hereby waive, release, absolve, indemnify, and agree to hold harmless the organization, its officers and its coaches. I agree that any fees be paid in full at signups. I am financially responsible for any and all equipment issued to said applicant other than normal wear during the current season and will reimburse the Central State Spikes for any loss or damage to said equipment. The undersigned promises to pay for all equipment not returned on the required date, plus costs of collection, including attorneys' fees. I fully understand that there are NO REFUNDS after equipment has been issued, and that there is a $15.00 charge for all returned checks.

Agree To Terms Of Parent/Guardian Agreement:

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