Bland Tigers Baseball/Softball

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2018 BYSA Application

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Phone:

Birthdate:

Gender:

Grade:

Uniform Jersey Size (please select):

Preferred Jersey Number (please put 2 preferred numbers):

PARENTS/GUARDIANS

Firstname:

Lastname:

EMail:

Home Phone:

Dad Cell#:

Mom cell#:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

I/We the parents or guardian of the above applicant for a position on the BYSA team hereby give my my/our approval for his/her participation in any and all BYSA activities.

I/We assume all risk and hazards incidental to such participation including to and from the activities and I/We do hereby waive, release, absolve, indemnify and agree to hold harmless the BYSA and all organizations BYSA is associated with, the organizers, sponsors, participants and persons transporting the above applicant, except and in the amount covered by the accident or liability insurance.

I/We will furnish a certified birth certificate of the above applicant upon request.

I/We agree to pay a player participation fee for the above applicant if and when a fee is established.

I/We agree to abide by the decision of the BYSA's official or any individual city or community associated the BYSA, as of the selection of the above applicant for a player position, team and/or league.

I/We the parents or guardian of the above applicant agree to fill our voluntary position in the concession stand or pay the appropriate fee as designated by the BYSA.

***Note: Inaccurate information on this form can result in the applicant's ineligibility for participation in current year activities.

I/we agree with the above *

Signature:

Date:

* indicates required fields

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2018 BYSA Application