PARENT INFORMATION (Please Print)

Last Name:

First Name:

Home Phone: (      )

Alternate Phone: (      )

Email:

Emergency Contact: (      )                                    

Address:

PLAYER INFORMATION

Last Name:

First Name:

Address: 

City:

Zip:

Birthdate: 

Age as of 4/30/08:  

Boy   /   Girl

Has Player Previously participated in University Park Baseball or Softball? 

VOLUNTEER INFORMATION

University Park Association for Youth Baseball and Softball is run by volunteers and
your help is needed for all levels of play! Please select your level of participation below.

Father

Mother

Father

Mother

Head Coach:

Concessions:

Asst. Coach:

Special Events:

Team Parent:

Fundraising:

Umpire:

Board of Directors:

Concessions:

Transportation:

Special Events:

Other: (Please Specify)

REGISTRATION FEES

Division

Shetland

(T-Ball)

Pinto & Mustang

Bronco

Pony

Girls Softball

Ages 

4-6

7-10

11-12

13-14

9-14

Fees 

$50

$65

$65

$65

$50

The deadline for registration is April 1, 2008.  There will be a $10 late fee for registrations received after the deadline. Returned checks will be charged a $30 handling fee.

UNIFORM INFORMATION (Please Circle One)

SPECIAL REQUESTS

Adult:      Small         Medium         Large         X-Large

Youth:     Small         Medium         Large         X-Large

LIABILITY AND MEDICAL TREATMENT RELEASE

I,____________________________ ,do hereby give approval for ____________________________

         ^{Parent or guardian of registered child                                                                      Name of child}

to participate in any and all league activities during the current season.  I assume all risks and hazards incidental to such participation, including transportation to and from activities and do hereby waive, release, indemnify, and agree to hold harmless the local league association, University Park Association for Youth Baseball and Softball, UPRP Softball Club, organizers, officers, sponsors, participants, property owners and persons transporting the child to and from activities for and claims arising out of an injury to any child.

I also grant permission to management personnel or other league representative to authorize and obtain medical care from any licensed physician, hospital or medical clinic should the child become ill or injured while participating in league activities away from home or at any time when parent or guardian is not available to grant authorization for emergency treatment.

I agree to return, upon request, the pants or other equipment issued to the child in as good of condition as when received, except for normal wear and tear.

Player’s pre-existing medical condition, if any:

Signature:

Relationship:

Date:

For League Use Only                                                                             Registration Fee:____________

Birth Certificate: On File____ Received_______ Uniform Size______ Cash______ Check #_______