PO Box 72983
Papakura
Auckland 2244
Phone: 09 299 8960
Email: [email protected]
www.countiessoftball.org.nz
Individual Player Registration Form
This form MUST be attached to the team scorecard and handed in to the Association Office. Failure to
complete all necessary sections will result in the appropriate penalty being imposed.
PLEASE PRINT CLEARLY
PART 1 – Player Details
Surname
Male
First Name
Female
Address
Contact Number
Date of play
Signature
PART 2 – Game Details
Club
Grade
PART 3 – To be completed only if players are under the age of 18
Date of birth
Parent Signature
PART 4 – Club Secretary Sign Off
Signature
Date
Declaration: The information contained herein is used solely for the administrative purposes of Counties Manukau
Softball Association Inc as defined in the PRIVACY ACT 1993, and will not be passed on to an outside party without
the written permission of the individual concerned.
CMSA OFFICE USE ONLY
Approved:
Yes
No
Date Received: _________________________
CMSA Secretary’s signature: ______________________________