2009 Fall Adult Softball League Team Registration Form
Recreation Administrative Offices (828)757-2165 - Fax (828)758-1315 Martin Luther King Center (828)757-2170 Lenoir Aquatic & Fitness Center (828)757-2196 Mulberry Recreation Center (828)757-2165 www.cityoflenoir.com/parks
General Information
Teams may consist of up to 18 player Season begins Tentatively September 3, 2009 Games will be played at Mulberry Recreation Center Center located at 720 Mulberry St. SW, Lenoir, N.C. 28645. 18 & over Picture ID’s are required form all player’s & coaches Only team registration will be accepted
Registration Information
Registration Starts: Monday, July 13th Team Name: Registration Ends: Friday, August 14th Registration Fee: $575.00
Manager’s / Coach’s Name:
E-mail Address:
Home #:
Cell #:
Work #:
Secondary Team Contact:
E-mail Address:
Home #:
Cell #:
Work #:
Registration forms may be mailed to Lenoir Parks & Recreation P.O. Box 958 Lenoir N.C. 28645. Please make checks payable to Lenoir Parks & Recreation (LPR).
2009 Spring Adult Softball League Team Registration Form
Recreation Administrative Offices (828)757-2165 - Fax (828)758-1315 Martin Luther King Center (828)757-2170 Lenoir Aquatic & Fitness Center (828)757-2196 Mulberry Recreation Center (828)757-2165 www.cityoflenoir.com/parks
Waiver, Release of Liability & Indemnification Agreement
I, the undersigned player, acknowledge, agree and understand that: Voluntarily & of my own free will I elect to participate as a member of the team indicated on this roster in the City of Lenoir Parks & Recreation Department Adult League. I understand that there are certain risks & hazards involved in participating in sports that may result in injury or death to me or other players, including but not limited to those hazards associated with weather, field / facility conditions, equipment, & other participants. I understand that the very nature of athletic events is hazardous or risky, including, but not limited to the acts of pitching, throwing, fielding & catching the ball, the swinging of the bat, running, jumping, stretching, sliding, diving & collisions with other players or stationary objects, all of which can cause serious injury or death to me & other players. Furthermore, I the undersigned player, agree that in consideration for the right to play as a member of the team designated on this roster & in consideration for permission to play at the facility arranged for by the team or league: I voluntarily elect to accept & assume all risks of injury incurred or suffered by me (a) while practicing as a member of the team so designated, (b) while serving in a non-playing capacity as a team member during practice or play by other teams or by players on my team & while on or upon the premises of any & all of the facilities arranged for by my team or league for practice or play. I release, discharge & agree to hold harmless the team designated on this roster, the City of Lenoir, the field owner, or their owners, officers, agents, servants, associations, employees or any person or entity connected with the team, league or facility for any claim damages, costs or cause of action which I have or may have in the future as a result of injuries or damages sustained or incurred by me from whatever cause including but not limited to the negligence, breach of contract or wrongful conduct of the parties hereby released.
Team Roster
Team Name:
Check One:
Date:
□ Men’s Open
□ Church
Check One:
□ Basketball
□ Softball
Player Affidavit: Each player must read & agree to the waiver/release form and to this statement before they can participate. I understand that by signing this roster I am under contract to play for the above named team. I certify that the below information is correct, & I am aware that I can not play on another Lenoir Parks & Recreation adult team within the same sport for the current season. I agree to abide by all rules set forth by the Lenoir Parks & Recreation Department. Furthermore, I acknowledge that I have read & that I understand each & every one of the provisions of the Waiver, Release of Liability and Indemnification Agreement & agree to abide by them. Additionally, I understand that alcoholic beverages & weapons are not permitted on city or school property.
Player’s Name (Print)
1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18.
Mailing Address
Phone #
Age
Player’s Signature
I certify that the information given above is correct to the best of my knowledge. In addition, I am aware that it is my responsibility to inform my players of all the rules of the Lenoir Parks and Recreation Adult League. Also, it is my responsibility to pass on all practice, game and tournament information as well as information on rescheduled games. Manager’s/Coach’s Signature: Church Pastors Signature (If Church Team): Cash: Check: Rect #: Date: Date: Amount: Schedules Capt. Mtg.