2017 - 2018 Softball Registration Form
For up-to-date information visit
(One player per form)
Player’s Name:
Birth date (mm/dd/yy):______
Street Address:______
Age as of 01/01/18: ______
City, State, Zip Code:______Experience (yrs):______
Home Phone Number:______Fall / Spring Sports: ______
Team played on last year: School currently attending: ______
Primary E-mail Address: ______
Primary Position: ______Secondary Position: ______Other Positions: ______
Allergies/Medical Information:
Please list any allergies/medical issues, including those requiring maintenance medications (i.e., Diabetic, Asthma, and Seizure Disorder). We understand this information is confidential and will be shared with only board members and player’s coach. The purpose of this information is to ensure that medical personnel have details of any medical problem, which may interfere with or alter medical treatment:
Parent/Guardian Information:
Mother’s Name: ______Father’s Name:______
Guardian’s Name:
Home Phone: Cell Phone:______
Emergency Contact Information:
In the event the parents or guardian can’t be reached please provide the name of an individual who can serve as the emergency contact.
Contact Name: ______Phone Number:______
Volunteer Information
(IMPORTANT! BE SURE AND READ AND MAKE A SELECTION)
LOWER PERKIOMEN PERKETTESdbaX-tremeFastpitch coaches and administrators are volunteers and give their time to provide an enjoyable experience for your child. Many volunteers are needed to assure that the best softball program is provided for the ladies of Lower Perk X-treme. Each parent or guardian is required to participate during the season especially tournaments. If you have a specific area or areas you wish to volunteer for please note by checking the areas where you can be of help. Home tournaments run by the organization require the help and assistance from every parent for field maintenance or snack bar duties. You will be required to assist at those tournaments when your team does not play.
Volunteer Options: (the players, and the Coaches thank you!)
Team Administrator / Fundraising / Website / Equipment / Snack Bar / Uniforms*Volunteers will be given a description from their respective coach on the duties and expectations for the selection made.
Lower Perkiomen PerkettesdbaX-tremeFastpitch
Liability Waiver Form
In consideration of my child being allowed to participate in any athletic/sports events sponsored by LOWER PERKIOMEN PERKETTESdbaX-TREMEFastpitchand any related events and activities, and intending to be legally bound, the undersigned:
1)Acknowledges and fully understands that each participant will be engaging in activities that involve risk of injury, which might result not only from their own actions, inaction or negligence of others, the rule of play, or the conditions of the premises or of any equipment used. Further that there may be other risks not known to me or not reasonably foreseeable at this time.
2)Assume all the forgoing risks and accept personal responsibility for the damages following such injury.
3)Release, waive, discharge and covenant not to sue the LOWER PERKIOMEN PERKETTESdba X-TREMEFastpitch, its administrators, directors, agents, coaches, and other employees or volunteers of the organization, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct league activities, all of whom are herein referred to as “releases”, for demands, losses, or damages on account of injury, caused or alleged to be caused in whole or in part by negligence of the releases or otherwise.
4)Acknowledges and fully understands that participating and playing in the Lower Perkiomen PerkettesdbaX-tremeFastpitchorganization is a privilege and that all players and parents will conduct themselves in accordance with the parent and player code of conduct.
5)Acknowledges and fully understands that any player selected to represent Lower Perkiomen PerkettesdbaX-tremeFastpitch travel and tournament team is not guaranteed playing time on Sunday.
The undersigned has read the above waiver and release, understand that I have given up substantial rights by signing it, and sign it voluntarily. I also understand that the above-mentioned player may participate in only one organized youth softball league unless otherwise obtaining permission from the President of Lower Perkiomen PerkettesdbaX-tremeFastpitch and the individual players coach.
Note: It is required that all players, parents, guests and league representatives adhere to the objectives of the league as defined in the Code of Conduct of the LOWER PERKIOMEN PERKETTESdba X-TREMEFastpitch which states: The objectives of the LOWER PERKIOMEN PERKETTESdba X-TREME Fastpitchshall be to instill in the children of the community the ideals of good sportsmanship, fair play, competition, and respect for authority, also to provide fun and recreation.
Signature of Parent / Guardian: ______Date: ______
Softball Divisions
10u, 12u, 14u, 16u, 18u
* Please note; TRYOUTS ARE MANDATORY FOR PLACEMENT ONTO A TEAM.
**Players are encouraged to attend as many of the tryout dates as possible.
***If there are multiple teams in an age group, please refer to the website and read an introduction for each coach’s team to help you understand their goals and provide a better description of the team that your daughter is looking to play for.
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