Little League Player Registration Form printable pdf download

North Metro Little League Player Registration Form

Player Information

Player’s Medical Information

Player’s Dental Information

Dentist: _____________________

Name:______________________

Physician: ___________________

Phone: ______________________

Birth-date: _____/_____/_____

Grade: _____

Male

Female

Insurance Carrier: _____________

Address: ___________________

Policy/Group ID: ______________

City: ______________ Zip:_____

Dental Insurance Same as Medical

School: _____________________

Please list any allergies or otherwise notable medical

Uniform Size:

Adult

Youth

Small

Med

Large

Other ____

problems or conditions of the player: ____________

Previous NMLL Player:

Yes

____________________________________________

If Yes, which team/coach: ________________________________

Parent (Secondary Contact)

Emergency Contact

Parent (Primary Point of Contact)

Name:______________________

Home Phone: ____-_____-_____

Phone: ____-_____-_____

Home Phone: ____-_____-_____

Cell Phone: ____-_____-_____

Relationship to player: _____________

Cell Phone: ____-_____-_____

Email: _____________________

League Volunteer

Email: _____________________

Preferred Method of Contact:

Note: In the event of an emergency and we

Preferred Method of Contact:

Home Phone

Cell Phone

are unable to reach you at any phone number

Home Phone

Cell Phone

League Volunteer

provided, we will try your emergency contact.

League Volunteer

I/We, the parents/guardians of the above named candidate for a position on a Little League team, hereby give my/our approval to participate in

any and all Little League activities, including transportation to and from the activities.

I/We know that the participation in baseball or so ball may result in serious injuries and protective equipment doe not prevent all injuries to

players, and do hereby waive, release, absolve, indemnify and are to hold harmless the local Little League, Little League Baseball, Incorporated,

the organizers, sponsors, supervisors, participants and persons transporting my/our child to and from activities from any claim arising out of any

injury to my/our child whether the result of negligence or any other cause.

I/We agree to return upon request the uniform and other equipment issued to my/our child in as good conditions as when recieved except for

normal wear and tear.

I/We agree that our child (candidate) may be required to try out for a team. If such does not attend at least 50% of the tryouts, local Board-

of-Directors approval is required for such candidate to be placed on a team.

I/We understand that our child (candidate) may be chosen at any time to play on a Major Division team if he or she is of the correct age for such

division as determined by the local league and Little League Baseball. Declining to move up to such Major Division team will result in forfeiture of

eligibility for the Major Division for the current season, and may be subject to further restrictions by the local league.

I/We agree to provide proof of legal residence (as de ned by Little League Baseball, Incorporated) and age. I/We understand that our child

(candidate) must be eligible under residence and age regulations of Little League Baseball, Incorporate, to participate in this Local League

and that if any controversary arises regarding residence and/or age, the decision of the Charter Committee in Williamsport shall be nal and

binding. I/We further understand that if any participant on a Little League Team does not qualify for participation in the league based on

residence (as de ned by Little League Baseball, Incorporated) and/or age, such participant and/or teamon which he/she participates be found

ineigible, and forfeit(s) and/or suspension of Tournament provoleges may be decreed by action of the Charter Committee or Tournament

Committee.

Note: Parents are responsible for providing proof of residence before league activities begin and must be within established boundaries

set by Coloeado District 2 Little League. See for details on NMLL boundary Information.

I/We will furnish a certi ed birth certi cate of the above named candidate to League o cials.

Please initial if NMLL has your permission to use your child’s likeness for marketing materials, including photographs, audio and video during games, practices

and sponsored events for marketing purposes including, but not limited to our leagues websites. Parents initals: __________

Parent/Guardian Signature: ___________________________________________________

Date: _____/_____/_____

Parent/Guardian Name (Printed) _______________________________________________

NMLL LEAGUE USE ONLY

Registration Year: __________ In Boundaries:

Yes

Birth Certi ate:

Yes

No Proof of Residence:

Yes

Medical Release:

Yes

League Age: _____

Division: __________

Payment Amount: _________________ Payment Type:

Cash

Charge

Check (number) _____

Last Modi ed: Jan 2016

For further information about North Metro Little League please visit our site at

Little League Player Registration Form

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