Amount Paid _______ Cash_____ Check #________
Credit/Debit Card Used ____
Baseball/Softball $75 (Includes hat, shirt, liability insurance)
East Catoosa Athletic Association
www.eastcatoosa.com
Email: [email protected]
Registration Form
Check one
Baseball
Age: __________
DOB: _________ Years Played _____
Softball
Age: ___________ DOB: _________ Years Played _____
Player’s Name: ____________________________________________________________________
Parent/Guardian’s Name: ____________________________________________________________
Mailing Address: __________________________________________________________________
City/State ________________________________________________________________________
Phone: ______________________________________Cell Phone: ___________________________
Email Address: _____________________________________________________________________
Shirt Size: _____
Hat Size (Circle One)
Youth
Adult Small/Medium
Adult Large/XL
Jersey Number Requested (Not Guaranteed): _______
Are You Coming From Another Rec Organization? Yes______ Where?______________ No______
Comments: ________________________________________________________________________
Do Wish To Coach? ________ Assistant Coach? ________ (A criminal background check will be required)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the
Releasees, and for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all
liabilities incident to my minor child’s involvement or participation in East Catoosa Athletic Association programs as provided above, EVEN IF ARISING
FROM THEIR NEGLIGENCE, to the fullest extent permitted by law.
_________________________________________________ DATE SIGNED:_______________
(Parent/Guardian Signature)
Emergency Phone Number: (_____)_________________