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2014 Fall Ball Registration
PLAYER INFORMATION
*
First Name:
*
Last Name:
Street:
City:
State:
*
Age:
*
Birthdate:
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
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1990
1991
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1994
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1998
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2002
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2006
2007
2008
2009
2010
*
Grade:
K
1
2
3
4
5
6
7
8
9
10
11
12
*
Shirt Size:
YS
YM
YL
YXL
AS
AM
AL
AXL
PARENT/GUARDIAN
*
First name:
*
Last name:
*
EMail:
EMail #2:
*
Home Phone:
*
Cell Phone:
Cell Phone #2:
MEDICAL/EMERGENCY CONTACT INFORMATION
*
Emergency Contact:
*
Phone:
*
Relationship to Player:
*
Medical Problems:
WAIVER INFORMATION
RELEASE: I, the undersigned parent/guardian of my child listed above do hereby agree to forever refrain from making claim or bringing suit against the Borough of Kinnelon, the Kinnelon Recreation Commission, the Kinnelon Youth Baseball Association or any of their agents, servants, or employees and do further release and hold harmless the Borough of Kinnelon, the Kinnelon Recreation Commission, the Kinnelon Youth Baseball Association or any of their agents, servants, or employees on account of any and all claims, demands, damages, costs, loss of services, expenses, pain and suffering or personal injury arising out of any act or omission whether negligent or not, while said listed child is participating in any activity sponsored by the Kinnelon Recreation Commission or the Kinnelon Youth Baseball Association.
I/we agree with the above
*
* indicates required fields
IMPORTANT:
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