Highland Baseball Club - (Evansville, IN) - powered by LeagueLineup.com

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2019 Spring Challenger Registration Form

PLAYER INFORMATION

* First Name:

* Last Name:

* Street:

* City:

* State:

* Zip Code:

* Current Age:

* Birthdate:

Grade:

PARENT/GUARDIAN #1

Firstname:

Lastname:

Email:

Home Phone:

Cell Phone:

Text (do you send and receive)

PARENT/GUARDIAN #2

Lastname:

Firstname:

Email:

Home Phone:

Cell Phone:

Text (do you send and receive)

Challenger
All Ages
Fees are not required for participation

Each entry fee includes: Hat & t-shirt

* Division:

* Uniform Information:

NOTICE:

You are urged to provide your own equipment; bat, glove, batting helmet. If you are unable to provide, please contact Matt Pokorney.

Please indicate any medical information that would require special needs for this player::

If interested in being a HBC sponsor, please fill out the following:

Business Name:

Business Phone:

Contact Person:

Email Address:

We are always in need of people with special talents. Please list any special skills and/or abilities you may have to contribute to Highland Baseball Club: (such as electrician, plumbers, carpenters, own heavy equipment, computer skills, etc.):

Please indicate any medical information that would require special needs for this player:

I/We the parents or legal guardian (s) of the above named youth, hereby gives my/our approval for his/her participation in any and all activities of the Highland Baseball Club during the current session. I/We assume all risks and hazards incidental to the conduct of said activities of the Club including transportation to and from such activities. In the event of injury, or illness to any/our child, I/We in accordance with the Health Care Consent Law, Indiana Code 16-8-12-5 hereby grant authority to the Highland Baseball Club to consent to medical treatment for my/our child by a dully licensed health care provider as necessary in any/our absence. My/our child takes the following medications and/or has the following drug allergies and /or has the following health conditions:

I/We agree to be financially responsible for all reasonable charges for health care rendered pursuant to this authorization. I/We, have read this document in its entirety and understand that it is a legal document whereby and wherein I/We grant specific permission and legal rights to the Highland Baseball Club, it’s directors, and agents regarding my/our interest and the interest of my/our child.

* Yes / No:

Special Notes to HBC:

* indicates required fields