Harlem Little League: 2010 New Summer Ball Application

2010 SummerBall Application for Girls Softball Players Only

This form is only for children who did not play Spring 2010 Harlem Little League.

For Girls' Softball: Open to Girls who were ages 8-12 by December 31, 2009


		* - Required Fields

*Player's First Name:

*Player's Last Name:

*Date of Birth - mm/dd/yyyy:

*Gender:

*Sport:

*Address:

*Apartment:

*City:

*Zip:

*Does Your Child's Have Any Medical Conditions?:

*If yes, please provide condition and medications:

*Please Provide Emergency Contact Information (Other Than Yourself):
*Emergency Contact's Name:
*Emergency Contact's Phone:
*Contact Relationship to Player:

*Registering Parent's First and Last Name:

*Parent's Contact Email:

*Parent's Contact Telephone Number:

Parent & Guardian's Permissions and Understandings:

I/We the parents(s) or guardian(s) of the above individual player, hereby, give my/our approval for participation in any and all Harlem Little League activities, including transportation to and from scheduled activities.
I/We know that participation in baseball/softball may result in serious injuries, and that protective equipment may not prevent all injuries to players.
I/We do hereby waive, release, absolve, indemnify and agree to hold harmless Harlem Little League, Little League Baseball, Inc., organizers, sponsors, supervisors, volunteers and persons transporting by/our child to and from activities for any claim that may arise out of injury to my/our child in the amount covered by accident or liability insurance.
I/We authorize that in case of emergency, if family member is not present and cannot be reached, my child can be treated by Certified Emergency Personnel (EMT, First Responder, Emergency Room Physician, etc.)
I/We understand that Harlem Little League is an all volunteer organization where no one gets paid. Therefore, I/ We are expected to help out whenever and wherever possible to make the operations of the League run smoothly.
I/We will contact Harlem Little League immediately if my child(ren) no longer wish to play or cannot attend games consistently.
I/We give permission to Harlem Little League and Columbia University to use photographs and video of the above named minor in any publication, media release, promotional announcement electronic or otherwise. I/We agree that the above named minor, nor I/we, nor any family member, nor any organization is due any compensation if such images appear in any publication, media relase advertisement or promotional announcement, electronic or otherwise.

*Parent & Guardian's Agreement:

I/We have read and agreed to the permissions and understanding.
I/We are 18 years and older and the parent/legal guardian of the registered player.

*Please type your initials: