Central California Krush

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TRYOUT REGISTRATION FORM

Coach Preference (If applicable):

* AGE GROUP:

High School Graduation Year:

Other Age Group you wish to tryout for.:

* PLAYER NAME:

* BIRTH DATE:

* AGE:

* PLAYER E-MAIL:

* LIVES WITH ?:

* IS THERE ANOTHER SIBLING PLAYING OR TRYING OUT?:

IF YES, NAME AND AGE:

* SCHOOL ATTENDING IN AND WHAT CITY.:

SAT or ACT score, if taken:

* GPA:

POSITIONS PLAYED? PLEASE CHECK ONE OR MORE BOXES BELOW.

PITCHER

CATCHER

FIRST BASE

SECOND BASE

SHORT STOP

THIRD BASE

OUTFIELD

* LIST TEAMS PLAYED FOR, AGE GROUP AND COACH:

* PRIMARY PARENT OR GURDIAN CONTACT NAME:

* ADDRESS:

* CITY:

* ZIP:

* CELL PHONE:

* SECONDARY PHONE NUMBER:

* OCCUPATION:

* E-MAIL ADDRESS:

SECONDARY PARENT OR GUARDIAN NAME:

ADDRESS:

CITY:

ZIP:

CELL PHONE:

SECONDARY PHONE NUMBER:

OCCUPATION:

E-MAIL ADDRESS:

COMMENTS OR EXPLANATIONS OF INFORMATION ABOVE:

WAIVER -PLEASE READ CAREFULLY

I/We, the parents and or guardian of the above named candidate for a position on a league team, hereby give my/our approval to participate in any and all league activities. I /We assume the risk and hazards incidental to such participation, including transportation to and from the activities: and I/We do hereby waive, release, absolve indemnify and agree to hold harmless the local league, the chartering organization, the organizers, sponsors, participants and persons transporting my/our child to and from activities: For any claim arising out of an injury to my/our child, whether the result of negligence or from any other cause, except, to the extent and in the amount covered by accident and liability insurance. I/We understand that the insurance carried by this league covers only the amount that is not paid by my/our carrier. I/We agree to return upon request the uniform and other equipment issued to my/our child in as good condition as when issued except for normal wear and tear. I/We will furnish a certified birth certificate of the above named candidate to league officials.

CONSENT - PLEASE READ CAREFULLY

Consent for Medical Treatment (Minor)
I hereby give my consent for all medical care prescribed by a duly licensed Doctor of Medicine for the person above named as her parent or legal guardian. This care may be given under whatever conditions are necessary to preserve life, limb or well being of your child.

I certify that the facts set forth in this registration form are true and complete to the best of my knowledge.

Checking yes acts as both an agreement of the waiver, consent for medical treatment and signature. I understand that at least one parent must be present at tryouts to physically sign a copy of this form printed by Krush Staff.

YES *

Signature:

Date:

* indicates required fields

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TRYOUT REGISTRATION FORM