South River Elite

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2018-2019 South River Elite Fastpitch Tryouts Registrations

PLAYER INFORMATION

First Name:

Last Name:

Street:

City:

State:

Zip Code:

Phone:

Birthdate:

Age Group:

Grade:

ACCOUNT INFORMATION

EMail:

2nd Email Address:

Address:

City:

State:

Zip Code:

PARENT/GUARDIAN #1

First Name:

Last Name:

PARENT/GUARDIAN #2

First Name:

Last Name:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Company Phone Number:

Insurance Company:

Policy #:

Policy Holder Name:

Jersey Size:

UNIFORM

Pants Size:

WAIVER INFORMATION

As the parent or legal guardian of the child being registered. I hereby give my full consent and approval for my child to participate in the South River Elite, Inc. Fastpitch Softball league. 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 daughter participation and I am willing to assume these risks on behalf of my child. I hererby certify that my daughter is fully capable of participating in the designated sport and that my daughter is healthy and has no physical or mental disabilities or infirmities that would restrict full participation in these activities except as listed above.

In addition to giving my full consent for my daughter's participation. I do hereby waive, release and hold harmless South River Elite, Inc., as well as their officers, coaches, and sponsors for any injury that may be suffered by my child in the normal course of participation in the sport and the activities incidental thereto whether the result of negligence or any other cause.

I/we agree with the above *

At this time we are only taking checks.

Please mail to:
South River Elite
217 Maryland Avenue, Edgewater MD 21037

NO LATER THAN AUGUST 31, 2015 in order to have Uniforms in time for first tournament.

Signature:

Date:

* indicates required fields

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2018-2019 South River Elite Fastpitch Tryouts Registrations