Player Name ______________________________________________ Parent Name____________________________________________________
Address__________________________________________________________________________________________________________________
City______________________ State_____________ Zip_____________________________________________
Primary Phone ____________________________________Secondary Phone ___________________________________
Birthday______/______/______ Age on December 31st: ____________________ Grade _____________________
Primary E-mail Address_____________________________________________-_______________________________________________
I/we the parent(s) of the above named candidate registering for a position on a team of the Paola Girls Softball Associations, hereby give my/our approval to her participation in any and all PGSA activities during the season. I/we assume all risks and hazards incidental to such participation, including transportation to and from the activities; and I/we do hereby waive, release, absolve, indemnify and agree to hold harmless the PGSA, the organizers, sponsors, supervisors, participants and person transporting my/our daughter, except to extent covered by liability insurance. I/we agree to return upon request, the uniform and other equipment issued to our daughter in as good a condition as when received, except for normal wear and tear.
PARENTS SIGNATURE____________________________________________DATE______/_______/______
PRINT PARENTS NAME ____________________________________________________________________
I WILL: COACH_____ AST. COACH______ UMPIRE ____ SPONSOR A TEAM_________
I WILL HELP WITH: CONCESSIONS_______ FUNDRAISING EVENTS_______ TOURNAMENTS_______
Special Needs or Requests_________________________________________________(Subject to PGSA Board Approval)ANY QUESTIONS, CALL Curtis Darby @ 294-9045 or Bruce Morgan 731-3351