2017-Remsen Youth Summer Ball Program
Player Registration Form
**Information can be found on Facebook-Remsen Youth and Rec
Sign up for TEXT Alerts @ lemarsdailysentinel.com
(Local sports-Remsen-choose Remsen Youth & Rec)
Birth Date:
Age:
Gender: M / F
Name:
Street Address:
Current Grade: PK K 1 2 3 4 5 6 7 8
School:____________________________
City, State, Zip:
Email Parent/Guardian:
1:____________________________________________
2:____________________________________________
Parent/Guardian name(s)
1:______________________________________
2:
Email
Parent
2:_________________________________
Cell
Phone
Parent/Guardian
1:
______
Cell Phone Parent/Guardian 2:_____________________
** The success of the Remsen Youth Summer Ball Program relies on the support of volunteers.
Please indicate the willingness to volunteer if any of the roles listed below.
**Please note: National Little League rules require a mandatory background check on all volunteers. ALL
volunteers must complete a form and conform to a background check.
□Head coach (Shirt Size:___________)
□Assistant Coach (Shirt Size:________)
Please check one box to indicate program/division for this player:
T-Ball (Co-ed)
□ T-ball (TK-K)
MUST be 5 by
May 1, 2017
Game Night TBD
□
□
□
□
Boy’s Baseball
Coach pitch (1st, 2nd )
Minors (3rd, 4th)
Majors (5th, 6th)
NWI-Majors (7th, 8th)
Coach Pitch, Minors, Majors play
Monday/Wednesdays
NWI-Majors play Monday/Thursday
***(Grade during 2016-2017 school year)***
**Please note: Due to the potential to create and imbalance in teams, we cannot honor requests to be on the same team (except for siblings).
Girls Softball NWI SOFTBALL LEAGUE
□ Grades K & 1st (coach pitch)
□ Grades 2 & 3 Minis (modified )
□ Grades 4 & 5 (Minors)
□ Grades 6, 7,8 (Majors)
Girls softball play on Tuesdays and Thursdays
***(Grade during 2016-2017 school year)***
My child has my permission to participate in the program indicated on this form. He/she is in good physical condition and has no health problems
that would prevent active participation. I agree to abide by all rules of the Remsen Youth & Rec Summer Ball Program as well as other agencies
involved in Leagues. I agree to hold harmless the Remsen Youth & Rec Summer Ball Program and any of its agents or affiliates in the event of
injury sustained by my child. I also grant permission for my child to be photographed and pictures released for publication for purposes of the
Remsen Youth & Rec Summer Ball Program or any of its affiliates.
Parent Signature: ____________________________________________________
Player T-shirt and hat information:
Each T-ball and coach pitch player will get a T-shirt, and hat/visor.
Travel, Minor, and Major Player will be supplied a jersey, pants, and hat/visor.
Circle shirt size: Youth S M L
Adult S M L XL XXL
ENTRY DEADLINE FEBRUARY 13 2017
Fee Schedule (includes t-shirt)
FOR INTERNAL LEAGUE ONLY
Date of registration:_____________
PROGRAM
T-ball
Baseball (Coach
Pitch/Travel)
Baseball
(Minors/Majors)
Softball (Coach
Pitch, Minis)
Softball
(Minors/Majors)
LATE FEE
REGISTRATION $
$15.00
$35.00
Amount enclosed: $
Cash
Check #
$55.00
$35.00
$55.00
$20.00
TOTAL AMOUNT ENCLOSED: $_________________
Cash__________Check #___________
______________________________________________________________________________________________________________
All forms must be accompanied by the appropriate registration fee per player.
Please make checks payable to: “Remsen Youth League”.
***FORMS MUST BE RECEIVED BY FEBRUARY 13 2017***
If form is turned in after this date please add $20.00 late fee.