Norton Youth Fast Pitch Softball Registration Form
Name: ____________________________________________________ Birth Date: ___________________________
(First) (Last) (mm/dd/yyyy)
Address: _________________________________________________________ Phone: ________________________
(Street) (City, Zip) (preferred contact)
Current Grade: _______ School Attending: _________________________________ Age on Jan 1, 2011: _______
Division (circle one): 8U 10U 12U 14U Fee (circle one): $80 $100 -$20 Cash _____ Check # _________
(Fees: $80 for 8U, $100 for 10U, 12U, 14U, $80 for each additional player)
(-$20 if using last years’ uniform)
Parents/Guardians >
Relationship >
Phone Numbers >
e-mails (notifications) >
I/We the parents/guardian of the above named candidate for a position in the Norton Youth Fast Pitch Association,
hereby give my/our approval to her participation in any and all activities. I/We, assume all risks and hazards incidental
to such participation, including transportation to and from all activities. I/We hereby waive, release, absolve, indemnify
and agree to hold harmless Norton Youth Fast Pitch Softball Association, Supervisors, participants and person
transporting my/our daughter to or from activities for claims arising out of and injury to my/our daughter, whether the
result of negligence or for any other cause.
I/We give consent, in case of an emergency, for our daughter to be treated by local emergency service, and transported to
_______________________________________ Hospital if I/we cannot be reached.
I/We will furnish a copy of our daughter’s Certified Birth Certificate to league officials at time of registration.
Signature: _____________________________________________________________ Date: _________________
(Parent/Guardian)
Interest in: Head Coach Asst. Coach Team Parent
Have you played before (circle one): Yes No If so, last year’s coach: _____________________________
Shirt (circle one): Youth XS S M L Last years’ #_________
Adult XS S M L XL
Short (circle one): Youth XS S M L
Adult XS S M L XL
Interested in Travel Tournaments: Yes No