Prince Jazz X Registration

PRINCE JAZZ X

FLORIDA

Athlete Information

Player Name*

First NameLast Name

Age*

Guardian / Parents Names*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone*

Area CodePhone Number

Cell Phone

Area CodePhone Number

E-mail*

Baseball skill level*

	1	2	3	4	5

1 is Beginner, 5 is Advanced

Important Notes:

Evaluation Process:All players participating in the travel ball program will be evaluated during practices, games, and events. Selection for the Prince Jazz X team is a highly competitive process, and only those who demonstrate exceptional ability and commitment will be chosen.

Commitment Requirement:Players selected for the Prince Jazz X team must be fully committed to attending all practices, games, and tournaments as scheduled. Dedication to team success and personal development is a priority.

Player Development Focus:Our program emphasizes not only competitive performance but also the personal and athletic growth of every player.

There is a $0 tryout fee for all participants. All fees must be paid in full upon completing registration.

No refunds will be issued after payment is received due to no shows or late arrivals.

ZELLE:anferneeseymour@princejazzx.com
VENMO:dj-collie
CASHAPP:$DominiqueCollie

Brief Description of Desired Goals at End of Program:

Emergency Contact & Health Insurance Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Area CodePhone Number

Do you have any allergies, chronic illness, or medical conditions that would limit high level activity?*

YesNo

Please describe*

Parental/Guardian Permission For Emergency Treatment

In the event of illness or accident, I give my permission for emergency treatment by qualified medical personnel for my child. I give consent for the facility to secure any and all necessary emergency medical care for my child.

Parent/Guardian's Signature

Date

Release of Liability

Although the safety of all sport activities is the primary concern, indoor sport activities at Youth Sport Center's facilities may cause injuries and/or death. I expressly assume the risk of injury, death, and/or illness arising from any cause, and agree to waive the right to pursue any claim against The Anfernee Seymour Foundation and the persons in charge.

I have read and agree to the above conditions*

YesNo

Confirmation E-mail*

Parent/Guardian's Signature*

After completing this form, please click Submit Form. You will receive a confirmation email. If you do not receive the email within a few minutes, please check your spam; otherwise, please contact us at info@princejazzx.com