The Firecrackers Central California 18 Gold and Showcase Team

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Firecrackers Central California Tryout Form

PLAYER INFORMATION

* Firecracker CC Age Group Trying Out For::

* Last Name:

Player Skill or Game Video (Use URL from Youtube):

Please provide information on your travel ball experience and where you are at in the recruitment process:

Age Group and Head Coach Preference:

* First Name:

Street:

City:

State:

Zip Code:

Home Phone:

Birthdate:

Email:

* High School Graduation Year:

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

The undersigned, the parent(s) or legal guardian(s) of the above named minor, hereby authorize my child’s coach or
any other official of the Firecrackers Central California to consent to any medical examination or treatment, including
hospitalization and/or surgery, which is deemed advisable, appropriate or necessary by duly licensed physicians,
emergency medical technicians, paramedics or other medical practitioners in order to properly care for my child in the
event she sustains injury or is suffering from any illness during the course of any playing or non-playing activities of
the Firecrackers Central California; provided, however, the foregoing consent or authorization shall be valid only in a situation where a parent or legal guardian of the above named minor is not reasonably available to provide the necessary consent to medical treatment. I also give my permission for my child to represent the Firecrackers Central California, a competitive fast pitch softball team, and to accompany her team to any of its local or out of town tournaments, games or practices. In the event my child is injured or becomes ill during the course of any playing or non-playing activities of the Central Firecrackers Central California, I hereby authorize her coach or any other official of the Firecrackers Central California to administer or obtain appropriate first aid, and if necessary, to transport my child to a physician or hospital for further treatment. I hereby consent to my child’s participation in any and all activities of the Firecrackers Central California, and I agree to release, indemnify and hold harmless the Firecrackers Central California, and its officers, directors, and agents, from and against any liability of any kind arising out of the activities of the Firecrackers Central California or transportation to and from such activities. I understand that participation in competitive athletics involves risk of physical injury or death which cannot be totally eliminated. However, players may reduce such risk by following a proper conditioning program, wearing or using helmets and other appropriate safety equipment, and properly reporting any injury to their coaches. In allowing my child to participate in the activities of the Firecrackers Central California, I understand that I am expressly assuming the risks referred to above and releasing the Firecrackers Central California from any and all liability arising out of or relating to the activities giving rise to such risks.

I/we agree with the above *

Signature:

Date:

* indicates required fields

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Firecrackers Central California Tryout Form