Please Fill in All the Requested Family and Player Data in the Boxes Below. a Player Cannot

Please fill in all the requested family and player data in the boxes below. A player cannot participate until form is completed and submitted to MYS.

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PARENTAL & CONTACT INFORMATION:

Guardian’s Last Name

Guardian’s First Name

Relationship to PlayerMother Father

Other

Mailing Address:

Street:

Town:Medway

State:MA

Zip:02053

Email Address: @.com

Home Phone Number

Cell Phone

PLAYER INFORMATION:

First Name

Last Name

DOB

Grade: (2013-14) Has played before ____

Registration fees:

(1) Pitchers & Catchers clinic

4 sessions (2 weeks, 4 days – August 5, 7, 12, & 14th)= $40 ___

(2) Skills clinic (infield/outfield & hitting)

4 sessions (2 weeks, 4 days – August 19, 21, 26 and 28th) = $20 ___

(3) Both= **$50 ___

Please check Pitching/Catching, Skills or Both
** $50 is discounted price for registering for both sessions – separately cost is $60

Media Permission - I grant permission to allow my daughter’s picture be displayed on MYS material or website.

Wavier Statement:

I, the undersigned parent or guardian of the within named registrant, by execution of this registration form, agree that we will abide by all of the rules and regulations of Medway Youth Softball, governing participation in this program. In consideration of accepting our registration, I hereby for myself and the registrant waive and release any and all claims we may have against Medway Youth Softball, Inc., its agents, officers, directors or members. I assume all liability arising out of the registrant's participation in Medway Youth Softball Inc.'s programs, including injury or death, fully acknowledging all of the risks and hazards inherent in the game of softball and hereby voluntarily assuming all such risks of loss or damage.

Signature of Parent or Guardian:

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Please bring the registration form and a check made out to Medway Youth Softball for the correct amount ($40 for Pitching/Catching, $20 for Skills or $50 for both) when you arrive for the first clinic and present that and a completed/signed registration form to the clinic coordinator or send a check and the signed registration form (please note SUMMER CLINIC on the memo section of your check) to:

MEDWAY YOUTH SOFTBALL

PO BOX 133

MEDWAY, MA. 02053

If you are interested in supporting MYS, please check the appropriate box below. Note that the role of Head Coach is to manage the day-to-day activities of the team while the Assistant Coach(s) supports the Head Coach. The role of the Team Parent is to assist with administrative duties such as making phone calls and fund raising.

Head Coach Asst. Coach Team Parent

NOTE - Those applying for Head Coaching and Assistant Coaching positions must fill out a CORI form along with a Volunteer Disclosure Statement and a Medway Youth Softball Coach’s Contract.

MYS Summer Clinics Reg Form -072013