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2010 North Liberty Youth League
Player Registration Form
Mail to P.O. Box 427 North Liberty, IN 46554
(ONE FORM PER CHILD PLEASE)
Player name ____________________________________________________________Parents Names_________________________________________
Address ______________________________________________________________________________________________________________________
Birthdate ___________________ Home phone ___________________________________Cell Phone__________________________________________
Emergency Contact____________________________________________________Emergency Phone_______________
Gender M/F_____ Age as of July 15th, 2010___________ Grade_____________Email Address_________________________________
Registering For: (Check one) ______T-Ball (Boys and Girls 5-6yrs old) ______Transition (Boys and Girls 7-8yrs old) ______Minor Softball (Girls 9-12yrs old) ______ Minor Baseball (Boys 9-12 yrs old)_________Major Softball (Girls 13-16yrs old) ______Major Baseball (Boys 13-15 yrs old)
Check if New Player ______ Last Years Team______________________________________________________________________
Shirt Size: YOUTH: S(6-8) ____ M(10-12) _____ L(14-16)_____ (Please go large in the event you are unsure)
ADULT: S(34-36)____ M(38-40)_____ L(42-44)_____ XL(46-48)_____ XXL(50-52)______
Pants: Pants may be ordered through the NLYL for $10. (Adult Size $13) Each athlete is required to wear regulation game pants(GREY) with the exclusion of T-Ball. (If you are ordering, please remember to add the price of pants to your registration fees.)
Pant Size: YOUTH: S ____ M _____ L_____ XL_____ ($10.00) ADULT: S____ M_____ L_____ XL_____ ($13.00)
Registration Costs: Includes 1 port a pit ticket per child. Good at the NLYL Port-a–pit event only
1 Child = $55.00 Includes 1 port a pit ticket
2 Children =$105.00 Includes 2 port a pit tickets
3 Children = $145.00 Includes 3 port a pit tickets
Pertinent Medical Information Circle One
Allergies Y/N Explain______________________________________________ Inhaler Y/N __________
Seizueres Y/N Additional Information for NLYL_________________________________________________
Other ________________________________________________________________________________________
Legal
1. I/We, the parents/guardians of the above-named candidate for a position on a North Liberty Youth League (NLYL) team, hereby give my/our approval to participate in any and all NLYL activities, including transportation to and from the activities.
2. I/We know that participation in baseball or softball may result in serious injuries and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnify, and agree to hold harmless the NLYL Incorporated, the NLYL board, sponsors, supervisors, participants, and persons transporting my/our child to and from activities from any claim arising out of any injury to my/our child whether the result of negligence or for any other cause.
3. I,/We as a parent(s) or legal guardian, certify that the above named youth has been pronounced physically fit by a physician to participate in the NLYL, INC. I release board members from all responsibility in respect to injury or accident.
Parent/Guardian Signature _______________________________________________________________Date_________________