UNION COUNTY SENIOR SOFTBALL LEAGUE
2013 REGISTRATION
Lets Play Ball and Have Some Fun
PLEASE PRINT CLEARLY:
Last
Name: _____________________________
First Name: ________________________
Street
Address: _________________________________________________________________
City or Town: ___________________________________ Zip Code: ___________
Home
Phone: ________________________________ Uniform shirt size: ________
Email
address: ___________________________________________________________
Would you like to receive
league communications at this email address in 2013? YES NO (Circle
One)
Date of Birth: ___________________________ Age on
1. Have you participated in the UCSSL
previously? YES NO (Circle One)
2. If you answered YES above, what
team(s) did you play on?
(50s)
________________________________ (60s) _________________________________
3. Are you currently assigned to a
team(s)?
(50s) ________________________________ (60s) _________________________________
4. Are
you interested in playing in a new 65+ Division at minimal cost? YES NO (Circle One)
(likely to be played as doubleheaders
on Thursday mornings)
** NOTE: all NEW players must submit a
photocopy of both sides of their drivers license **
Cost for membership in the UCSSL
.
$75.00
Total cost to play in both the
50s and 60s
$135.00
All players: Please read the following, and sign where indicated.
The
STATEMENT OF DISCHARGE OF LIABILITY
I sign this form as my Voluntary Act and by this act I
agree to exclude the Union County Senior Softball League and all of its
officers and League officials from any claims, suits or other actions arising
from, caused by, or which are the alleged result of any Act or omission by the
League.
I agree to participate in League play in the Union
County Senior Softball League at my own risk and any injuries which I may incur will be
paid for through my own personal medical plan or from my own personal funds.
This statement remains in effect as long as I
participate in the
I hereby certify that the above information is correct, and I realize that I am liable to be banned from UCSSL for life if the information is found to be false.
LEGAL SIGNATURE: ____________________________________ DATE:__________________
Return completed form, with payment (and copies of license if you are new to the league),
to team manager, or mail to: UCSSL 938