PERMISSION SLIP SHOALS SUMMER LEAGUE 2010

www.shoalssummerleague.org email: shoalssummerleague@hotmail.com

______________________________has my permission to play in the SHOALS SUMMER BASEBALL PROGRAM.

_____________________________has insurance at home to cover him/her in case of injury.

Date of Birth ____________________ Age on April 30th, 2010 _______________________________

Parents Name________________________________________ Phone __________________________

Parents Name________________________________________ Phone __________________________

Address ____________________________________________________________________________

In case of emergency call _______________________________ Phone __________________________

Allergies or Handicaps, etc. _____________________________________________________________

ELIGIBILITY RULE – Players must not be 13 years old before May 1, 2010.

The fee is $30.00 for the first child and $15.00 for each additional child from your family (Please contact us if you can not afford this due to hardship). If you have any questions please call Harold Bleemel @936-4018 or Mark Hawkins @ 295-2905.

Last year’s team your child played on (if any)___________________________?

SPECIAL NOTE: ***BY SIGNING YOUR CHILD UP FOR SUMMER BASEBALL, YOU WILL BE REQUIRED TO WORK AT LEAST TWO (2) GAMES DURING THE SEASON IN THE CONCESSION STAND UNLESS YOU PAY $20 TO COVER THE LOST REVENUE. WITHOUT CONCESSIONS WE WILL HAVE TO RAISE THE FEES.*** I am paying $20 yes no.

I understand that participation in baseball may result in serious injuries and that protective equipment does not prevent all injuries to players, and I hereby waive, release, absolve, indemnify and agree to hold harmless Shoals Summer League, Cal Ripken Baseball, the organizers, supervisors, and participants for any claim arising out of injury to my child whether the result of negligence or for any other cause, except to the extent and the amount covered by accident or liability insurance.

Date _____________ Signature of Parent / Guardian _________________________________________

I am interested in coaching ____ (check if yes) Umpiring ______

______________________________________________________________________________________

BRING THIS FORM WITH YOU WHEN YOU REGISTER. DO NOT RETURN IT TO SCHOOL.

Players Name _____________________________ _________(Please Print Clearly)

Please check one: Child’s Size: 6-8 _____ 10-12 _____ 14-16 _____

Adult Size: S _____ M _____ L _____

Note: The T-shirts will be a 50 / 50 blend of cotton and polyester and run a little on the small side.

Feb. 1^st @ Shoals Cafeteria (6-8 pm) & FEB. 6^Th @ Shoals Library (9-11 am).Forms can be mailed to:

SSL

PO Box 119

Shoals, IN or dropped off at the County Prosecutor’s office.