West Coast Storm Baseball Inc - (Norco, CA) - powered by LeagueLineup.com

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YOUTH PLAYER REGISTRATION FORM

PLAYER INFORMATION

* First Name:

* Last Name:

Street:

City:

State:

Zip Code:

Home Phone:

Birthdate:

Gender:

* Grade:

PARENT/GUARDIAN #1

* Firstname:

Lastname:

EMail:

* Cell Phone:

PARENT/GUARDIAN #2

Firstname:

Lastname:

Email:

Cell Phone:

West Coast Storm Baseball Inc. and West Coast Professional Baseball Facility Llc. are both fully Insured with Both Player and Staff coverage. We are a Secondary coverage to your Family/Personal Coverage.Please let us know if you do not have Medical insurance so we can take appropriate action.

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

* Insurance Carrier:

* Policy #:

BASEBALL EXPERIENCE,AGE, LEAGUES,TEAMS,PRIVATE LESSONS,ETC.:

WHAT DAYS AND TIMES ARE CONVENIENT DURING SCHOOL WEEK TO PRACTICE:

In order for us to better understand your child, if he/she has a learning disability whether it be physical/emotional, please talk to us so that we both have a great beginning together.Knowledge and Understanding goes a long way in achieving Success.:

WAIVER INFORMATION

I HERBY CERTIFY THAT: I am the parent or legal guardian of the above-named player who wishes to participate in organized baseball under the auspices of West Coast Professional Baseball Facility LLC and/or West Coast Storm Baseball Inc..

I understand that baseball can be a hazardous activity which may subject participants to serious injury. Nevertheless I, on behalf of my son or ward, my self and my spouse, herby agree to assume all risk to which my son may be exposed due to his activities and participation, directly or indirectly, in connection with West Coast Storm Baseball Inc and/or West Coast Professional Baseball Facility Programs. I specifically release, absolve, indemnify and hold harmless West Coast Storm Baseball Inc. Board, and all officers, directors, sponsors, organizers, managers, coaches, supervisor, employees, and volunteers thereof from any liability resulting therefrom.

I/we agree with the above *

Signature:

Date:

Signature:

Date:

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