Challenger Baseball 2019 Registration Form

Athlete Information

Athlete's Name

First NameLast Name

Birth Date

MonthDayYear

Grade

Age:

Gender

MaleFemale

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Jersey Size:

Does your player have communication difficulties?

If yes, what are some tips for easiest communication for our volunteers?

Parent/Guardian Information

Name

First NameLast Name

Home Number

Area CodePhone Number

Cell Number

Area CodePhone Number

E-mail

Emergency Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Area CodePhone Number

Alt. Phone Number

Area CodePhone Number

Informed Consent and Acknowledgement

I, the undersigned, release and forever discharge Paradise Minor Baseball association, including its Executive, Coaches, workers and all others involved in the organization and delivery of its programs and activities of and from all claims, demands, actions or causes of actions arising or to arise by reason of physical injury to the child named above, caused to him/her while participating in organized activities of Paradise Minor Baseball Association or
while traveling with a Paradise Minor Baseball team. By signing this form I also authorize representatives of the Paradise Minor Baseball Association to provide appropriate medical assistance to my child in my/our absence.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.