EXTREME FALL BALL PLAYER REGISTRATION SOFTBALL BC LIFETIME # __________ PLAYER NAME: _________________________ YEAR BORN: ________ HOME CLUB 2015: _____________________________ ADDRESS:______________________________________________________ ______________________________________________________________ HOME PHONE: ________________________ BC CARE CARD # _____________________________________ DOCTOR NAME: ______________________ PHONE: ___________________ DENTIST NAME: _____________________ PHONE: ___________________ CIRCLE PREFERRED GROUP: TUES & SUN (’99-’97) WED & SUN (’03-’00) THURS & SUN (’07-’04) PLEASE CIRCLE INFIELD POSITIONS YOU ARE WILLING TO PLAY: PITCHER CATCHER 1ST BASE 2ND BASE 3RD BASE SHORTSTOP PLEASE CIRCLE T-SHIRT SIZE YM YL YXL S M L XL 1 FRIEND TO BE SURE IS ON MY TEAM: ___________________________ GUARDIAN INFORMATION: 1. GUARDIAN NAME: _____________________________ HOME PHONE: ___________________ CELL PHONE: _____________________ EMAIL: ________________________________ 2. GUARDIAN NAME: _____________________________ HOME PHONE: ___________________ CELL PHONE: _____________________ EMAIL: ________________________________ EXTRA EMERGENCY CONTACT:________________________________ _________________________________________________________ ***WILLING TO COACH? NAME:___________________________________ Please make $50 cheques out to: Central Saanich and District Fastpitch Assoc. Mail form and cheque to: Extreme Fastpitch, PO Box 333, Brentwood Bay, BC V8M 1R3 FIRST COME, FIRST SERVED!!!!
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