Fillable Player Information Form printable pdf download

Player Information Form

Player’s Full Name: __________________________________________________________________________________

DOB (mm/dd/yyyy): ____/____/_________

School Grade: _______ Throws (R/L): ________ Bats (R/L): ________

Jersey Size (YL, XS, S, M, L, XL, XXL): ________ Hat Size (XS/S, S/M, L/XL): ________ Hat Size (Fitted): ____________

Co‐op day(s) and ending time(s): _______________________________________________________________________

Home Address: _____________________________________________________________________________________

Home Phone: ___________________ Player Email Address: _______________________________________________

Player Cell/Text Number: ___________________ Parent Cell/Text Number(s):_________________________________

Parent Name(s): ____________________________________________________________________________________

Parent Email Address(es): ____________________________________________________________________________

Medical Release

In the event of any injury or emergency, if I or my emergency contact cannot be notified, I authorize the individual(s) in

charge to obtain medical treatment for my child as deemed necessary by competent medical personnel. Additionally, I

understand that I am fully responsible for any and all charges incurred due to such treatment.

Medications taken:__________________________________________________________________________________

Known allergies: ____________________________________________________________________________________

Any other pertinent medical history: ____________________________________________________________________

__________________________________________________________________________________________________

Doctor’s name: __________________________________________ Doctor’s Phone: ____________________________

Doctor’s address: ___________________________________________________________________________________

Insurance Information: Provider: _____________________________________ Policy #__________________________

Emergency contact (other than parent): Name: __________________________________________________________

Relationship to Player: ________________________________________________ Phone: _______________________

PARENT’S SIGNATURE: ____________________________________________ DATE: _______________

Form must be submitted to coaching staff at first practice. This form is in effect for the 2015-16 baseball season only.

Player Information Form