Deerlick Girls Softball

Slow pitch or Fast Pitch

Childs Birthdate

MonthDayYear

Age Group

Registration Fees

Coach Pitch Registration$75.00

Fast Pitch Registration$90.00

Douglas County Non-Resident Fee$25.00

Total $0.00

You will be refunded $5 each additional child that you register, maximum payment is for 3 children.

You can Submit your application and pay later or Submit & Pay to pay with your credit/ debit card now

Players First Name

Players Last Name

E-mail

Mother/Parent/ Guardian Name

Phone Number

Secondary Number

Father/Parent/ Guardian Name

Phone Number

Secondary Number

Relationship of person registering player

Address

City

State

Zip Code

Health Insurance Provider

Any Special Medical needs or conditions

Special Request (team or coach)

I/We the parent(s)/guardian of the above name player do hereby give my/our approval to participate in any and all girls softball activities. I/We assume all risk and hazards incidental to such participation including transportation to and from activities and so hereby waive, release and absolve, indemnify and agree to hold harmless girls softball officials, organizers, sponsors, supervisors, participants, and persons transporting my/our daughter to and from activities for any claim arising out of an injury to my/our daughter. Any parent or guardian verbally or physically abusing a Head Coach, Assistant Coach, Official or other persons participating in a game or practice, his or her child may be suspended from attending any league participation for one year and the parent or guardian suspended from attending any league or play-off sponsored by the club for the same period. Incidents must be in writing to the Deerlick board of directors.

Medical Release: I fully understand that Deerlick Girls Softball Association does not provide insurance and it is my responsibility to provide insurance coverage for the above named player. Deerlick Girls Softball Association, directors, sponsors, supervisors, participants, and volunteer staff will not assume liability for injuries incurred by the above
named player during participation in any softball activities. I do hereby waive, release and absolve, indemnify
and agree to hold harmless Deerlick Girls Softball Association, directors, sponsors, supervisors, participants,
and volunteer staff for any claim arising out of an injury to the above named player.

In case of an emergency involving the above named player, which in the opinion of Deerlick Girls Softball Association requires medical attention, I authorize the Association representatives to take such emergency action as may be deemed necessary, including the transportation of the above named player to a hospital or medical center and authorizing medical treatment. I assume the responsibility for any medical expenses incurred during any emergency medical treatment. I have carefully read and understand each of the above sections and will comply with these policies and statements.

By checking and submitting this form you agree to above statements

Registration Fees*

Registration Fees