Logan Township Youth Baseball Association

2017 New Player Registration

This registration system is for players NEW to LTYBA

If your child has already played for LTYBA in the Minor or Major Leagues, your coach will collect your registration info before the season starts.

PLAYER INFORMATION

* Full Name:

* Street:

* City:

* State:

* Zip Code:

* Birthdate:

* Gender:

* Grade:

* School Attending:

* League Played for Last Year:

If OTHER Please Specify:

Team Played for Last Year:

PARENT/GUARDIAN #1

* Full Name:

* Email:

* Phone:

PARENT/GUARDIAN #2

Full Name:

Email:

Phone:

MEDICAL/EMERGENCY CONTACT INFORMATION

Emergency Contact:

Phone:

Relationship to Player:

Insurance Carrier:

Primary Physician:

Specified Conditions which treatment staff should know:

CONSENT FOR PARTICIPATION AND TREATMENT

I, the undersigned, state that I am the parent or guardian of the player that I am registering and agree that my child may play baseball in the program conducted by the Logan Twp. Youth Baseball Assoc. and agree that my child and I will be subject to and abide by the rules and regulations established by LTYBA.

The risk of injury from the activities involved in the program is significant, including the potential for permanent paralysis and death, and while particular rules, equipment, and personal discipline may reduce the risk, the risk of serious injury does exist and, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume all full responsibility for my child’s participation; and, I willingly agree to comply with the stated and customary terms and conditions for participation. If however I observe any unusual significant hazard during my presence or participation, I will remove my child from participation and bring such to the attention of the nearest official immediately; and I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS THE LOGAN TWP YOUTH BASEBALL ASSOCIATION, there officers, officials, agents and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("Releases"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

I/we agree to never forget that this is a program to teach young children the basics and rules of team sports, and that all participants need my support and encouragement.

I/we agree to never criticize publicly the officiating of any game or an individual official, player or coach.

I/we agree to abide by the rules and procedures established for the program by LTYBA.

I/we will submit any complaints or suggestions to LTYBA in writing, and will accept their decisions as final.

I/we agree to return upon request, or by the end of the said season, the uniform and other equipment issued to my/our child(ren) in as good of conditions as when received except for normal wear and tear. Failure to return issued equipment may result in my child’s registration application being denied the next year.

As the Parent or guardian of the player I am registering, a MINOR, I herewith authorize treatment by a qualified and licensed medical doctor in the event of a medical emergency which; in the opinion of the attending physician may endanger his/her life, cause disfigurement, physical impairment, or undue discomfort if delayed. This authority is granted only after reasonable effort has been made to reach me.

I/we agree with the above *

* indicates required fields

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2017 New Player Registration