Fillable Player Exemption Form printable pdf download

Player Exemption Form

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CITY OF SALEM SOFTBALL LEAGUES

PLAYER EXEMPTION FORM

All fields are required.

INSTRUCTIONS:

A separate form is required for each player requesting an exemption from the

league eligibilty rules. This form must be submitted and approved by the Softball Coordinator or Softball Specialist two

days prior to player being allowed to play in a game of a lower classification level.

Player Name _______________________________________________________________________________________

Phone __________________________________________

Date ___________________________________________

Email Address

___________________________________________________________________________________________________

Team requesting to play on __________________________________________________________________________

Indicate your current rating, if applicable:

ASA ____________________________________________

USSSA _________________________________________

List the team(s) that you played for last season:

___________________________________________________________________________________________________

If you listed more than one team above, which was your primary team last season?

___________________________________________________________________________________________________

Reason for exemption request:

___________________________________________________________________________________________________

SEND THIS FORM TO:

LEAGUE DIRECTORS

Attention: Billy Powers

Billy Powers

City of Salem Public Works Department

Maggie Combs

555 Liberty Street SE, RM 325

Office Phone 503-588-6261

Salem, OR 97301-3513

Fax 503-588-6025

WEBSITE

Registration forms and additional information are available

CITY OF SALEM

1 of 1

REVISED 03/05/2015

Player Exemption Form

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