Whitfield Baseball Association

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WBA 2020 Spring Registration

PLAYER INFORMATION

* First Name:

* Last Name:

* Age:

Street:

City:

State:

Zip Code:

* Home Phone:

* Birthdate:

Gender:

Grade:

* Shirt Size:

PARENT/GUARDIAN #1

* Firstname:

* Lastname:

* EMail:

Home Phone:

Work Phone:

Cell Phone:

Are you interested in helping coach?:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Home Phone:

Work Phone:

Cell Phone:

Are you interested in helping coach?:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Carrier:

Policy #:

WAIVER INFORMATION

I hereby give my child permission to participate in the Whitfield Baseball Association Program. While I realize that all precautions will be taken to guard my child from injury, I will not hold the Whitfield Baseball Association, directors, coaches or staff, responsible for accidents that may occur. I also understand my commitment to help with concessions, field maintenance, and support the program.

I/we agree with the above *

* indicates required fields

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WBA 2020 Spring Registration