Lancaster Minor Baseball & Softball Association
BASEBALL 2011 PLAYER REGISTRATION FORM
Players Name____________________________________ Birth Date: _____/_______/_______
Month / day / year
Medicare #:_________________________________________ Gender (M/F)_______________
Address:___________________________________ City:___________ Postal Code:_________
Email: ____________________________________Emergency Contact #:__________________
Mother’s Name: ____________________________Phone: ______________________________
Father’s Name:_____________________________Phone: ______________________________
2011 PLAYER DIVISIONS
(Select Division that corresponds with the year of birth of player.)
3-pitch (2007/2006 / 2005) _________________ Minor LL (2004 / 2003) __________________
Major LL (2002 / 2001 / 2000) _______Junior LL(1999 / 1998 / 1997) ____________________
Bantam (1996 / 1995) _______________ Midget (1994 / 1993 / 1992) ___________________
*Interested in trying out for Rep Team _____________
Make the 2011 Season the Best Season Yet! Become a Volunteer!
Coach __________ Assistant Coach_____ Scorekeeper ______ Equipment Mgr. ______
Canteen ______ Special Events ______ Other:_________________________________
*Coaching Application must be completed to be considered for a coaching position.
I hereby waive and release Lancaster Minor Baseball/Softball Inc., its agents, representatives, coaches, officials, directors, and
sponsors from any claim or actions from any injury which might be received by my child during any Association activities. I certify
the above mentioned date of birth is correct and am willing to provide proof if necessary. I realize players are not insured and are not
permitted at tryout or on the field until registration is complete, i.e. registration form completed in full, signed by parent/guardian,
Medicare care number filled in, proof of date of birth supplied, if required and registration fee is paid in full. I am also aware that the
association and the player’s coach should be made aware of any relevant medical condition as soon as possible.
Make athletic participation for your child and others a positive experience.
Be kind to your child’s coach and officials. The coach is a volunteer giving personal time to provide an athletic activity for your
child. The coach is providing a valuable community service, often without reward other than the personal satisfaction of having
served his or her community.
The opponents are necessary friends. Without them your child could not participate meaningfully. Applaud good plays by your
team and by members of the opposing team.
Parents are asked not to voice their displeasure with the way their child or child’s team is playing or with the calls that the referees are
making. Parents are asked to set an example for their children and show respect for all the people on the field; players, referees and
minor officials. Keep in mind we are all here for the benefit of the players.
Signed: __________________________________________ Date: ______________________________
Coaches, parents, media outlets, and Lancaster Minor Baseball & Softball Association may take photos of players
participating in Association activities. These photos may be displayed on the Association website or submitted to local
newspapers and used in promotional materials. I consent to the use of images of myself and / or child as indicated above
2011 Baseball Fees: 3-pitch $55.00 Minor LL $70.00 Major LL/ Junior LL/ Bantam / Midget $95.00
Family Rate – each additional child will receive a $25.00 discount.
Additional Rep fees will apply if selected for a Rep team following tryouts.
Refund Fee $10. Registrations are non-refundable after July 1st.
For Lancaster Minor Baseball & Softball Association use only:
Total Received:__________(cash / cheque) Date:__________ Received by:_______________ Receipt issued: ___Yes ___No