2017 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 2017? 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)
.
$80.00
Total cost to play in both the
50s and 60s
$145.00
All players: Please read the following,
and sign where indicated.
The Union County Senior Softball League will not accept registration forms not signed!
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.