15U Springfield Giants

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Player Registration Form

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Phone:

Birthdate:

Email:

Gender:

Grade:

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 #:

WAIVER INFORMATION

1. Voluntarily and of my own free will, I elect to participate as a member
of the Springfield Giants 13U Baseball team indicated below.
2. I understand that there are certain risks and hazards involved in
participating in baseball that may result in injury or death to me or other
players including, but not limited to those hazards associated with
weather conditions, playing conditions, equipment, and other
participants.
3. I understand that sliding into base is dangerous to me and to other
players and may result in serious injury or death.
4. I understand that the very nature of the game of Baseball is hazardous
and risky, including, but not limited to, the acts of pitching, throwing,
fielding and catching of the ball, the swinging of the bat, running,
jumping, stretching, sliding, diving, and collisions with other players and
with stationary objects, all of which can cause serious injury or death to
me and to other players.
Further, I, the undersigned player, agree that in consideration for the
right to play as a member of team designated below and in
consideration for permission to play on the fields arranged for by the
team or league:

1. I voluntarily elect to accept and assume all risks of injury incurred or
suffered by me (a) while practicing or playing as a member of the team
so designated, (b) while serving in a non-playing capacity as a team
member during practice or play by other teams or by other players on
my team, and (c) while on or upon the premises of any and all of the
fields arranged for by my team or league for practice or play.
2. I release, discharge and agree not to sue the team and league
designated below, the fieldowner or other entity designated below, the
Nations Baseball or USSSA Baseball, or their owners, officers,
agents, servants, associations, employees, or any person or entity
connected with the team, league, field or, damages, costs or cause of action which I
have or may in the future have as a result of injuries or damages
sustained or incurred by me from whatever cause including but not
limited to the negligence, breach of contract or wrongful conduct of the
parties hereby released.

I/we agree with the above *

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Signature:

Date:

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