2010 Registration
2010 Registration is Closed.
Parent First Name: Last:
Parent First Name: Last:
Address:
City:   State:   Zipcode:
Phone: Alt Phone: Format: (999)999-9999
E-mail:
   
Participant #1 First Name: Last:
Participant DOB: (Format: YYYY-MM-DD)    Sex:
League:
Team/Coach Preference: Last Year Team/Coach:
Years of Experience: Position Preference:
   
Participant #2 First Name: Last:
Participant DOB: (Format: YYYY-MM-DD)    Sex:
League:
Team/Coach Preference: Last Year Team/Coach:
Years of Experience: Position Preference:
   
Participant #3 First Name: Last:
Participant DOB: (Format: YYYY-MM-DD)    Sex:
League:
Team/Coach Preference: Last Year Team/Coach:
Years of Experience: Position Preference:
   
Parent Interested In: Coach      Asst Coach      Fields      Concession      Picnic
   
In consideration of the registration fee paid, whereof is hereby acknowledged, and of my child/or ward being permitted to participate as a player in the AnJo Baseball League, and in anything connected therewith, I (we) as parent(s) listed above, individually and as a parent and/or guardian of the above named a minor(s), do hereby consent to such participation, assume all risk in connection therewith, release and discharge you, your agents, servants and employees, jointly or severally, from any and all liability, claim and actions whatsoever for damages or injury (including fatality) to said minor by reason of such participation or otherwise and said minor shall be subject to all reasonable rules and orders in connection therewith. I further agree to indemnify and hold you, jointly and severally, forever harmless against any loss or damage which the named child may sustain in consequence of such participation or otherwise, and that no other agreement, either verbal or written, shall in any manner affect this release. This release shall be binding upon the heirs, executors, and administrators of the said minor and myself. I hereby give permission for the photographs and videos of my child to be shown in promotional, informational, and website materials for the promotion of the AnJo Youth Baseball League.

 
By checking this box I have read and agree to the waiver statement above:

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