Middletown Little League Baseball and Softball
A Division of The Middletown Youth Athletic Association
APPLICATION TO PLAY SPRING 2010 BASEBALL &SOFTBALL
You can also signup using our FREE online registration
OUR HOME PAGE IS www.middletownlittleleague.org
ALL PLAYERS MUST RESIDE WITHIN THE BOUNDARIES OF MYAA LITTLE LEAGUE AS APPROVED BY LITTLE LEAGUE HEADQUARTERS.
ANY PLAYERS LIVING IN ELEMENTARY SCHOOL DISTRICTS OF BAYVIEW, FAIRVIEW, HARMONY, LEONARDO (SOUTH OF RTE 35),
MIDDLETOWN VILLAGE, NEW MONMOUTH, OCEAN AVE, PORT MONMOUTH AND RIVER PLAZA.
*Denotes mandatory fields. Application will not be processed without!
LAST NAME: * ________________________________ FIRST: * ________________________ M. I.: ____
Birthdate:*___/ ___ /_____League Age: *___ (Boys: as of April 30, 2010/Girls: as of 12/31/2009) Sex:* (Male / Female)
Address: *____________________________________ Town: * ___________________, NJ ZIP: *_________
Home Phone: * (732) _____ - _________ Name of School: *__________________________ Grade: * _______
E-mail address: * ___________________________________________(This is the primary means of communication from the League)
Father’s name: * ______________ Cell:____________ Mother’s Name:_______________ Cell:______________
Does your child have any current condition (physical/medical) that limits his/her ability to participate in this activity? (Yes / No)
If yes, please explain_____________________________________________________________________________________________
I/We, the parents or guardians of the above named candidate, hereby give my/our approval to participation in any and all LITTLE LEAGUE activities, including transportation
to and from the activities under Middletown Little League(s), a division of Middletown Youth A. A. I/We agree to abide by all rules and regulations set forth by the organization.
The final interpretation of any rule rests with the Middletown Little League Board. I/We know participation in baseball or softball may result in serious injuries up to and
including death. I/We know protective equipment does not always prevent all injuries to player. I/We hereby do waive, release, absolve, indemnify and agree to hold harmless
Middletown Youth Athletic Association, Middletown Little League subsidiary, Little League Baseball Incorporated, League Officials, the organizers, sponsors, supervisors,
participants and persons transporting my/our child to and from activities for any claim arising out of any injury to my/our child whether the result of negligence or for any other
cause, except to the extent and in the amount covered by accident or liability insurance. I/We agree to return equipment issued to my/our child in good condition as when
received except for normal wear and tear. When asked, I/We will furnish a certified the birth certificate of the above named candidate to League Officials.
Parent(s) or Guardian Signature: ______________________________________________ Date: ________ ____, 2009/2010
*** PARENT / GUARDIAN MUST VOLUNTEER TWO HOURS TO WORK THE REFRESHMENT STAND OR PERFORM FIELD MAINTENANCE***
I/We would like to VOLUNTEER to be _____Manager ______Coach or to do _____Field Maintenance _______Snack Bar
Rutgers Safety Course Completion Date: ______________ Parents Occupation ________________________________________
All teams are drafted by the appointed managers, there are NO GUARANTEES that requests will be honored.
Middletown Little League Spring 2010 Divisions (Mark the appropriate division for your player’s league age)
BASEBALL Boys: Age as of April 30, 2010 SOFTBALL Girls: Age as of 12/31/2009
T-Ball Coed (5-6 yr olds) _______ $90.00 Rookie Girls Softball-Coach Pitch (7-8 yr olds) _______ $90.00
Rookie Boys-Coach Pitch (7-8 yr olds) _______ $90.00 Minor Girls Softball (9-10 yr olds) ______ $100.00
Pioneer Boys (8*- 9 yr olds) _______ $100.00 Major League Girls Softball (11-12 yr olds) ______ $100.00
Minor Boys (10-11 yr olds) _______$100.00 Junior/Senior League Girls Softball (13-16 yr olds)______$120.00
Major League Boys (10*-12 yr olds) ______ $100.00
Junior League Boys (13-14 yr old) _______ $120.00 Please make check(s) payable to:
Senior League Boys (14-16 yr olds) _______ $120.00 Middletown Little League
Big League Boys (17-18yr olds) _______ $150.00 Mail address: PO Box 127
*The League player agent will determine if younger players are needed to move up. Middletown, NJ 07748
FAMILY PLAN MAX: $240.00 + 1 Bond $75 = $315.00
LEAGUE USE ONLY
Amount: $ _________ (Cash) Check# _______
REGISTRATION FEES: $__________(FAMILY PLAN MAX $240.00) Family Plan: (Yes/No) ________of _________
VOLUNTEER BOND: +$ 75.00 (1 BOND PER FAMILY) Received by: ___________________________
TOTAL AMOUNT: $__________