2016 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: ______ number: _______
Email address: _________________________________________________________________________
Would you like to receive
league communications at this email address in 2016? 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, for how
many consecutive years? ___________
3. If you answered YES above, what
team(s) did you play on?
(50s)
________________________________ (60s) _________________________________
4. Are you currently assigned to a
team(s)?
(50s) ________________________________ (60s)
_________________________________
** NOTE: all NEW players must submit a photocopy of both
sides of their drivers license **
Cost for membership in the UCSSL (on one
team)
$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 (preferred), or mail to: UCSSL