BLACKHAWK FAST PITCH SOFTBALL INC.
LEAGUE REGISTRATION FORM
SPRING 2016
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Player’s name (Last, First, M.I.) Address
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Player’s home phone number email address (for ease of communication)
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Father’s name; home ph. # if different from above father’s cell (optional – texting eases communication)
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Mother’s name; home ph. # if different from above mother’s cell (optional – texting eases communication)
______Circle age group of participation:
Player’s age Birthdate (mm/dd/yy) T-Shirt Size Shirt # 8U 10U 12U 15U 18U
2 choices
I would like to help my daughter’s team with the following: ( ) Team Parent ( ) Coaching
I ______agree that I and the above registrant will abide by the rules of
(parent/guardian)
Blackhawk Fast Pitch Softball Inc. and the BeaverCounty Girls Fast Pitch Softball League. Recognizing the
Possibility of physical injury associated with softball and in consideration for Blackhawk Fast Pitch Softball Inc.
excepting the registrant for its softball program, I hereby indemnify Blackhawk Fast Pitch Softball Inc., its coaches
and sponsors against any injury the registrant may sustain as a result of the participation in the activities of
Blackhawk Fast Pitch Softball Inc. Further, I certify that this child has no known previous or existing physical or
mental incapacities that would increase the normal risk of injury incurred through her participation in softball
activities. I also agree to participate in mandatory fundraising activities.
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Parent/Guardian Signature Date
I would like to sponsor a team or I know someone who is interested in sponsoring a team.
( ) Yes or ( ) NoContact name:
Contact phone number:
Registration fee:8U age group $45.00
All other age groups$75.00
Circle form of payment: Cash or Check Check # ______Amount $______
Make checks payable to: Blackhawk Fast Pitch Softball Inc. or B.F.P.S. Inc.
Mail all forms and check to:Audrey Amalia - 305 6th Street, Beaver Falls, PA 15010
Blackhawk Girls Fast Pitch Softball
Medical Release Form
In the event of sickness, accident, or injury, I/We give permission for my/our daughter, ______, to have administered to her whatever emergency treatment is deemed necessary by the attending doctor/nurse/medical technician.
My/Our daughter has the following medical conditions or allergies, which should be noted in case of sickness, accident, or injury. (E.G. asthmatic, diabetic, allergies to specific drugs, hyper reaction to bee stings, bleeds easily, etc.) Please indicate NONE if there are no known problems or conditions.
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Signature of Father of Legal Guardian Date
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Signature of Mother of Legal Guardian Insurance Company
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Address Policy Number
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City, State, Zip Code Family Physician
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Home Telephone Number Physician’s Phone Number
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Name of Nearest Relative
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Phone Number of Relative