Gastineau Channel Little League

Page 2

A Chartered Member of Little League Baseball ® Incorporated

My child will try out for ONE of these:Baseball ______Softball_______

Health/Accident Insurance Company:____________________________________________

Insured’s name and policy number:______________________________________________

I/We, the parents/guardians of the above named candidate for a position on a Little League team, hereby give my/our approval to participate in any and all Little League Activities, including transportation to and from the activities.

I/We know that participation in baseball or softball may result in serious injuries and protective equipment does not prevent all injuries to players, and do hereby waive, release, absolve, indemnify and agree to hold harmless the local Little League, Little League Baseball, Inc., 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.

I/We agree to return upon request the uniform and other equipment issued to my/our child in as good condition as when received except for normal wear and tear.

I/We agree that our child (candidate) may be required to try out for a team.If such candidate does not attend at least 50 percent of the tryouts, local Board of Directors approval is required for such candidate to be placed on a team.

I/We understand that our child (candidate) may be chosen at any time to play on a Major Division team, if he or she is of the correct age for such division as determined by the local league and Little League Baseball.Declining to move up to such Major Division team will result in forfeiture of eligibility for the Major Division for the current season, and may be subject to further restrictions by the local league.

I/We will furnish a certified birth certificate of the above-names candidate to League Officials.

Parent(s)/Guardian(s) signature:______________________________Date:________

______________________________ Date:________

Daytime Phone Number __________________  Message Phone Number __________________

Little League Baseball does not limit participation in its activities on the basis of disability, race, color, creed, national origin, gender or religious preference.

TO PAY REGISTRATION FEE USING CREDIT CARD:

Name as it appears on card:___________________________________

Account Number:___________________________________________

Expiration date:_____________________________VisaMastercard

Signature:__________________________________________________