FCFA REGISTRATION FORM
Age On 12/31______
$80.00 Per Player
Amt Paid__________
Treasurer:______________________
Cash or
Check#_________
VP:_____________________
Registrar:___________________
PLAYER INFORMATION
Name (First, MI, Last):
Date of birth:
Age:
Phone:
State:
ZIP Code:
Current address:
City:
School:
EMERGENCY INFO
Player Lives with (circle):
Both Parents
Mother
Father
Other:
Mother/Guardian Name:
Email:
Father/Guardian Name:
Phone:
Cell
Email:
Phone:
Cell:
DIVISION
Age Division (circle one): TBall
8U
10U
12U
14U
16U /18U
Div Played Previous: TBall 8U 10U 12U 14U 16U/18U
Team:
Team Requesting:
Positions Played:
RELEASE STATEMENTS
I/We, the parent/guardians of the registrant, agree that the registrant and we will abide by the rules of the FCFA
league. In the event league rules are not adhered to I/We understand that disciplinary actions will be taken. This
also includes behavior on the field/stands by those associated with the registrant.
I/We do further hereby release, absolve and hold harmless, the board of directors, sponsors, supervisors,
participants and any persons transporting my/our child to and from activities for any claim arising out of an
injury to my/our child, whether the result of negligence or for any other cause, except to the extent and in the
amount covered by accident or liability insurance.
I/We give permission to use my child’s picture and name on the FCFA Softball website and marketing materials.
I/We acknowledge forfeiture of all registration fees after my/our child has been assigned to a team. Refunds will
only be made only if requested, in writing, prior to the first day of games. No refunds will be given after your
child has been assigned to a team.
Dear Parents: We are always in need of volunteer help. Please indicate the position you would be
willing to accept:
Circle: Coach Manager Sponsor Board Member Assistant Coach Team Parent Other:
SIGNATURES
Signature of parent/guardian:
Date: