RMB*ATB Team/Event Registration Form

Four Corners Showdown Player/Event Registration Form Name State in First Box -AZ-CO-NM-UT
TEAM OR EVENT REGISTERING FOR*
Player's Name:*

First NameLast Name
School*
Age*
Graduation Year*
Player's Date Of Birth:

MonthDayYear
CURRENT HS GPA IF APPLICABLE*
Date

MonthDayYear
Date
Baseball Positions List By Primary and Secondary if Pitcher specify RHP or LHP*
Height*
Weight*
Shirt/Jersey Size Specify Adult or Youth*
Player's Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Player Email*
Player Cell*

Area CodePhone Number
Parent *

First NameLast Name
Parent Email*
Parent Cell*

Area CodePhone Number
Authorization For Emergency Treatment/Insurance/Liability Waiver

By submitting this form you give your consent for your child's participation in any and all ATB/RMB functions or activities. In the event of any injury or sickness occurring during any ATB/RMB functions or activities, you authorize any official(s) to administer first aid and if necessary to transport your child to the nearest emergency treatment.

You release ATB/RMB and any person(s) connected with ATB/RMB of any responsibility from accident or injury incurred as a result of his participation in any and all activities, including transportation to and from any ATB/RMB functions or activities.

You certify that you child has been given a physical examination and is physically able to participate in all related activities. Please notify in writing any prescribed medications and / or physical conditions of which the ATB/RMB coaches or staff should be aware of are listed below. Therefore i do not hold ATB/RMB instructors or staff liable.
Are there any medical conditions the staff needs to be aware of?
Health Insurance Information/Provider/PolicyNumber/Comments
In Case Of Emergency
Point Of Contact:*
Contact Number:*
Signed: Parent
Date:

MonthDayYear
Should be Empty:

Four Corners Showdown Player/Event Registration Form Name State in First Box -AZ-CO-NM-UT