2009 Recreation League
Registration
General Information: This registration form is used to register players
for the Denville PAL Girls Softball Recreation League. It is for players
attending Kindergarten through 12th grade.
Key Dates: Registration forms and fees are due by
January 10. A late fee will be assessed
for registrations received between January 11 and January 31. We will be unable to guarantee a spot on a
team for players whose registration forms are not received prior to January
31. These players will be added to a
waiting list and may be added to teams if spots become available. Refunds will not be provided after March 28.
Additional Forms: Additional forms can be printed from our web site by clicking the
“Forms” link from the Denville PAL Girls’ Softball Home page. The web site address is www.denvillesoftball.org.
Mail-In Registration Address: Mail completed registration forms and registration
fees to the following address:
Denville PAL Girls Softball
Registration Fees: Registration fees must accompany the registration form. Registration will not be complete until both
the registration form and fee have been received. Make checks payable to Denville PAL Girls Softball. The following fees apply:
On-Time
Registration (if received by January 10)
·
Kindergarten -
$30 per child up to 2, $5 for each additional child
·
1st
through 12th Grades - $60 per child up to 2; $15 for each additional
child
Late
Registration (if received after January 10)
·
Kindergarten -
$35 per child up to 2; $5 for each additional child
·
1st
through 12th Grades - $65 per child up to 2; $15 for each additional
child
Registration may
be verified by clicking on the “Registration Verification” link on the home
page of the Denville Softball website (www.denvillesoftball.org).
PLEASE COMPLETE THE FOLLOWING SIDE
No participation permitted without complete medical information.
P.A.L Girls’
Softball Registration 2009 Season
Please Print Clearly
(No participation permitted without complete medical information)
Player’s Current School Grade (K-12): _______________
Player Information:
Name:
___________________________________________
Date of Birth: ______________
Age: ______
Address:
________________________________________________________________________________
Town:
________________________________________
Zip Code: _________________
School:
_________________________________________________________________ Grade: _________
Doctor’s Name:
______________________________________________
Phone: _____________________
Medical Insurance Company
Name: ___________________________________________________________
Policy Number:
__________________________________________ _____ No medical insurance
Please describe any medical
or health problems your child may have:
________________________________
________________________________________________________________________________________
Does
your child take any medication? _______
If yes, please list medication & dosage taken each day:
________________________________________________________________________________________
Is
there medication to be taken in certain emergencies? _________
If yes, please describe:
________________________________________________________________________________________
Parent/Guardian Information:
Name
1: _______________________________________ Name 2:
_______________________________________
Phone: (Home 1): _____________________ (Work 1):
____________________ (Cell 1):
___________________
Phone: (Home 2): _____________________ (Work 2):
____________________ (Cell 2):
___________________
Email
Address 1: ________________________________
Email Address 2: _______________________________
Please indicate if you or
family member(s) can help P.A.L. Girls Softball this season:
|
_____ Head Coach |
_____ Assistant Coach |
|
_____ Team Parent |
_____ Board Member |
|
_____ Business Sponsor |
|
|
|
|
Name of individual willing to
help: ______________________________ Contact Number: _____________________
Media Approval:
Opportunities may be presented in which players names
or pictures can appear in local news papers, our website, our newsletters, or
other communications affiliated with Denville PAL Girls Softball. Please check the appropriate box below:
¨
You have my permission
to use my daughter’s name and picture in publications
¨
Please do not use
my daughters name or picture in publications
Registration Verification: Registration can be verified by clicking the
“Registration Verification” link on the home page of the Denville Softball
website (www.denvillesoftball.org).
Verification will be posted within 5 days of registration receipt.
I, the parent or guardian of
the above mentioned player, do hereby give permission in my absence for any
necessary emergency medical treatment to be administered by a licensed
physician or certified medical professional.
I also give my approval for her participation in travel softball
activities and assume all such risks and hazards incidental to participation
and absolve, indemnity and agree to hold harmless Denville P.A.L Girls’
Softball, its sponsors, directors, managers, coaches, and other participants.
Parent/Guardian Signature:
_______________________________________ Date: ______________
For Official Use Only: Amount __________ Check # __________