2018 Challenger Division Little League Registration
Register on line at www.challengerkalamazoo.com
Players Name______Birthday______Age______
Address______Zip______
Parent/Guardian Name______
Address______Zip______
Home Phone(___)______Cell (___)______Email: ______
Emergency Contact______Phone______
Doctor ______Phone______
School Attending______Circle: New Player Returning Player
Experience: Beginner Intermediate Advanced
Shirt Size: circle: Youth: S M L or Adult: S M L XL XXL
Buddy A. ___ I/We will obtain a Buddy for my player. B. _____ Please find a buddy for my player
If A, Buddy Name: ______Phone:______Email: ______
Photo Release
I hereby give the Challenger Little League the absolute and irrevocable right and permission, with respect to the photographs that have been taken of me or in which I may be included with others:
a. To use, re-use, publish, and re-publish the same, in whole or part, individually, or in conjunction with other photographs, in any medium and for any purpose whatsoever, including (but not by way of limitation) illustration, promotion and advertising and trade, television and multimedia, AND
b. To use my name in conjunction therewith if the Challenger Little League chooses.
I hereby release and discharge Challenger Little League, and third parties collaborating with Challenger Little League from any and all claims in connection to photo reproductions of me and/or my narrative account of my experience Challenger Little League as described herein.
I am the Mother/Father/Legal Guardian of ______(child’s name). For the consideration contained herein, I hereby consent to the foregoing on behalf of my child.
Parent/Guardian Signature ______Date: ______
Registration Fee $30 (scholarships available)
Return Completed form and fee to:
(Checks payable to Challenger Little League)
Challenger Little League, P.O. Box 1448, Portage, MI 49081-1448
Questions call (269) 668-8034 Please leave a message and someone will get back with you. Or email:
To Be Filled in by League Representative
New Players:(Birth Cert) ____ League Age _____ All players: Registration Paid Date______Check ___Cash
Registration closes March 1