Alb Registration Form #1
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1
2American Legion Baseball
2008 ALB Registration Form #1
Registration Form #1 MUST BE TYPED
Team Name
Jr. Legion
Sr. Legion
(ages 17 & under)
(ages 19 & under)
American Legion Post #:
Post Officer’s Name:
City and State:
Phone #:
Financial Booster:
Legion Card No:
Officer’s Signature:
Insurance Carrier: S.A. VAN DYK INS. CO. This insurance carrier is mandatory
Accident Insurance Cert. #:
Liability Insurance Cert. #:
Outside Sponsoring Organization (Complete this area if local Legion Post chooses not to affiliate as team sponsor).
Organization:
Phone No:
Address:
President:
City, State, Zip:
Signature:
Notice: This form must be filed with Department Baseball Chairman, along with the following forms:
1. Parents’ Consent and Release (Form #2)
2. Player’s Transfer (Form #76) or Declaration Form (Form #77) if applicable
Team Certification: As Team Manager I hereby certify that the players listed under PLAYER ROSTER (page 2 of this form) have signed
with this American Legion Baseball team and that all information listed is correct, to the best of my knowledge.
Manager:
E-mail:
Address:
Phone:
Is this team affiliated with a Jr. or Sr. Team?
YES
NO
Signed:
Coach:
E-mail:
Address:
Phone:
Coach:
E-mail:
Address:
Phone:
Department Certification:
Signature:
1. Team has properly registered by deadline.
Department Baseball Chairman
2. Team has purchased proper liability and medical insurance.
3. Team has filed Form #2, and Forms #76 & #77 if applicable.
School Classification and Enrollment: Certification is required from each school listed on player roster.
The Department Baseball Chairman may certify enrollments. Enrollments must be filed in National Office by June 1.
Certifying School
Name of School
As of March 31 - Total Enrollment
School Classification
Official’s Signature
(base school *)
of Grades 10, 11, 12
*
Public
*
Public
Public
Public
Public
Public
Public
Public
If additional schools need to be listed, attach separate sheet of paper.
21-021/Revised 12/2007
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Parent category: Life